A Picture of Health by Delineo

A Picture of Health in Bolton?

The Annual Report of The Director of Public Health for Bolton

2008-2009

Contents

Contents Chapter 1: The Bolton Health Survey 2007

Chapter 2: Health and symptoms of poor health

Chapter 3: Use of health services

Chapter 4: Lifestyles

Chapter 5: Mental health, social support and the health of carers

Chapter 6: Crime and the fear of crime

Chapter 7: Neighbourhood perceptions and problems

Chapter 8: Social and economic characteristics

Click on contents header to go to the relevant chapter

Chapter 1 The Bolton Health Survey 2007 The Bolton Health Survey was carried out during the summer of 2007, and whilst the results from the survey have been used extensively by ourselves and partners since then, this is the first publicly available document publishing the detailed results of the survey.

The Annual Report of the Director of Public Health for Bolton 2008 - 2009

A survey steering group was first convened during 2006. This group consisted of the most appropriate staff members from all parts of NHS Bolton and the Council along with representatives from the local voluntary sector and academic input from Bolton University. This group had full control over what questions were included in the survey, how the survey was to be carried out, sample size, levels of analysis and dissemination of findings.

Identifying questions for the 2007 survey As the previous survey in 2001 had such a good response, it was decided to follow the format and content of the 2001 survey as much as possible. This allows the new survey to monitor changes in the health and lifestyle of the population since 2001. The steering group used a number of criteria to decide on section and individual question inclusion. The main criteria concentrated on response rate in 2001 to individual questions, availability of new or more suitable questions, whether the question helped provide information about a priority area and the extent to which data from the question had been used from the previous survey. Alternative measures were sought for questions that had not worked so well in 2001. All but one of the questions that were eventually included in the Bolton Health Survey 2007 came from existing national or local health surveys and had therefore been through strict validation processes. Such sources include the Health Survey for England, the General Household Survey, the Office for National Statistics harmonised questions and recommended questions from the North West Public Health Observatory.

Ethical approval As for the previous survey, ethical approval was sought for the 2007 survey. Application was made to the Central Office for Research Ethics Committee. The application was reviewed by the Wigan Research Ethics Committee, who deemed the survey to be a repeat of a previous study that had already been ethically approved and so no new approval was necessary.

The Bolton Health Survey 2007

Steering Group

The question used to measure levels of physical activity was the exception to this and was designed by the steering group, as no existing question would provide us with the information necessary to gauge how Bolton was performing against Government recommended levels of physical activity.

Sampling frame The sampling frame for this survey, as for the previous survey, was the Bolton GP patient register. This contains the names and address details of all Bolton residents who are registered with a GP. It also contains demographic information such as sex, age and GP practice details. This is useful when wanting to analyse the results of the survey by certain population groups and at GP practice level. People aged eighteen or above were included in the sampling frame. One of the limitations of this sampling frame is that people who are not registered with a GP are excluded from the survey. This group may have different health status than the rest of the population and as we donâ&#x20AC;&#x2122;t know how many people are not registered with a GP in Bolton, we are unable to estimate what affect this will have on the reliability of the data from the survey.

Chapter 1

Detailed methodology

Sample size and stratification

Piloting the survey

The previous survey in 2001 had been designed to be analysed down to Electoral Ward level. Since then, many health and related statistics have moved away from using Electoral Ward as the geographical level of analysis and have since been shown at Lower and Middle Super Output Area (MSOA) level instead. These are geographies built up from Census Output Areas.

The questionnaire and processing system was piloted in April 2007 with a randomly selected 313 GP registered adult residents of Bolton. The aims of the pilot were to predict the overall response rate of the main survey and to determine whether respondents were willing to answer the questions included in the survey.

In 2001, a sample size of 5% of the adult population was calculated to be necessary for analysis at Electoral Ward level to be sufficiently robust. To be sufficiently robust at MSOA level, a 10% sample was necessary, assuming that the response rate might fall to around 55% as had other recent surveys in the North West. Sampling stratification is a method of ensuring that the survey sample is representative of the true population. To be representative of the true population, the proportions within the sample must be the same as in the general population. Simple random sampling methods will not always lead to a true representation. The prevalence of ill-health might be expected to vary with age, sex, and geographical location and so it was important that these characteristics were represented in the survey. In order to do this the sample was stratified by age group, sex and geography to ensure a representative sample. We also used survey response information from 2001 to over sample those population groups that responded less well during the previous survey. This included younger people (men in particular) and people living in the most deprived areas of Bolton. The overall final sample size for the 2007 survey came to almost 25,000 people.

The Annual Report of The Director of Public Health for Bolton 2008 - 2009

The response rate (without reminders) was similar to the same stage in 2001, approximately 30%, and the levels of missing data were low for each question. We received very few negative comments about the structure of the questionnaire or the questions included, so no changes were made to the questionnaire.

The main survey The main survey was a sixteen page, 51 question, A4 sized questionnaire booklet. Topics included in the final questionnaire were: • General health • Symptoms of ill-health • Pain • Mobility difficulties • Mental health • Social support • Use of health services • Physical activity • Alcohol • Smoking • Diet • Crime • Fear of crime • Socio-economics • Demographics • Caring • Height & weight • Neighbourhood issues and perceptions The first surveys were sent out in the week beginning 4th June 2007, accompanied by a covering letter from the Director of Public Health, explaining the purpose of the survey and a business reply envelope. Three subsequent reminders were sent to non-responders to improve the overall response rate: the first reminder postcard was sent in the week beginning 15th June, with a second letter and replacement questionnaire sent in the week beginning 2nd July and a final postcard reminder sent in the week beginning 16th July.

Analysis The first stage of analysis took place at a borough at MSOA level and looked for changes in health and lifestyle since 2001. These headline findings were reported to the NHS Bolton Board in December 2007 and have since been reported to a range of appropriate partnership groups. The next stage of analysis looked at Neighbourhood Renewal Strategy area level results to help inform the Neighbourhood Action Plans. The results were made available to staff from NHS Bolton and Bolton Council involved in Neighbourhood Renewal. For this report, as well as reporting on borough level and MSOA level results, the data has also been analysed by broad age/sex groups, major ethnic groups and deprivation quintiles to look for differences and inequalities within Bolton.

Age/sex group analysis In this report we have analysed the data by broad age/ sex groups: male 18-44 years, male 45-64 years, male

Main ethnic group analysis The health survey included a question asking for the ethnic group of the respondent. From this data, we have identified the main ethnic groups of people in Bolton. However, you will see that we incorporate 95% confidence interval limits into the bar charts used in the ethnicity analysis in this report. This is because for some ethnic groups, the numbers of respondents was quite small and so we show the likely range of results for all groups. For some of the groups with very few respondents, we have had to group them up into an ‘Other’ ethnic group category. The main ethnic groups that we have been able to analyse the survey data by are:

The Bolton Health Survey 2007

After excluding undelivered questionnaires and people who had died or moved away from the address, 53% of the total sample responded by returning their survey. We were very pleased to achieve this level of response and we are very grateful to everyone who responded.

65+ years, female 18-44 years, female 45-64 years and female 65+ years. The data displayed are actual raw results and have not been adjusted for response rate or population structure.

• White British • White Irish • White Other • Asian Indian • Asian Pakistani • Black • Mixed/Asian Other/Other As explained below, we have used standardised data to compare the results between the ethnic groups. This allows us to look for health inequalities between the main ethnic groups of Bolton.

Deprivation quintile analysis The postcode of the survey respondent was recorded alongside their survey data to allow us to analyse the data by geographical location. For the survey results shown at MSOA level, this is data aggregated up from postcode level. When looking at differences in results between levels of deprivation, we have used the Indices of Multiple Deprivation 2004 data at Lower Super Output Area

Chapter 1

A publicity campaign about the survey accompanied the first mailing. A press release was sent to local media which led to extensive coverage in the local press and radio. Posters about the survey were sent to all local health, council and community facilities across Bolton. A help-line was made available for people having difficulty answering the survey and translated surveys (in the main languages of people living in Bolton) were offered to people unable to read English.

(LSOA) level to assign a level of deprivation to each postcode in Bolton. The LSOA geography can be assigned to a quintile of deprivation level and hence so can each postcode. In this way, we can analyse each indicator to look for differences and associations in health with levels of deprivation. As explained below, we have used standardised data to compare the results between deprivation quintiles. Confidence limits have not been provided for this analysis as the ranges are not large. One of the limitations of this analysis is that because the Index of Multiple Deprivation is a geographical measure, it applies a single deprivation score to each LSOA. This assumes that everyone in that LSOA (of about 1,500 people) has the same level of deprivation. This may not be the case. However when the data is aggregated to deprivation quintiles across the whole borough, it is likely that this will not have a significant effect on the reliability of the results.

Geographical analysis As mentioned earlier, it was always our intention to be able to analyse the findings from the health survey at Middle Super Output Area. Super Output Areas are a new geographical hierarchy designed by the Office for National Statistics (ONS) to improve the consistent reporting of small area statistics. They are built up from 2001 Census Output Areas and so as a result, do not reflect communities or known local areas. ONS give each MSOA a code to identify them but we thought that for the purposes of this report we should attempt to name the areas to help the reader understand the areas that we are reporting on. We have therefore named each MSOA with our interpretation of the area covered by the geography. We have avoided giving any MSOA the exact same name as any Electoral Ward so to avoid confusion with this geography. The table showing geographical results and the maps at the end of each chapter show the results at named MSOA level. The Annual Report of The Director of Public Health for Bolton 2008 - 2009

Data weighting To smooth out differences in response rates between age groups and gender and between different areas, the results have been weighted by the underlying population data available from the Office for National Statistics. This adjusts the results, as if the population that responded was the same as the population as a whole. The results in this report for Bolton as a whole, and at MSOA level have been weighted. Weighted results are useful when planning service provision as they show the true level of health need in a particular area.

Data standardisation Standardising data adjusts the results to control for age and sex variations in different population groups. Thus, after the data has been standardised, any observed differences in results will not be due to a populationâ&#x20AC;&#x2122;s age and sex structure, instead they assume that each area or ethnic group has the same age and sex profile as Bolton as a whole. We have standardised the results in this report when analysing at ethnic group and deprivation level. Standardised results are useful when investigating inequalities in health as they permit comparisons to be made between the results for different population groups, in the knowledge that the results will not be confounded by age and sex differences.

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Chapter 2 Health and symptoms of poor health

The Annual Report of The Director of Public Health for Bolton 2008 - 2009

The first question of the Bolton Health Survey asked the respondent to grade their general health over the previous twelve months, with answers ranging from poor through to excellent. This question is an excellent predictor of health status. The table below shows the results for this question by sex. Male

Female

Bolton

% Excellent

14.7

12.0

13.3

V Good

29.8

29.7

Good

30.3

29.4

29.8

Fair

17.4

20.3

18.9

Poor

7.7

8.7

8.2

health and lower proportions in poor health than their female counterparts. The opposite can be said for the middle (45-64) years age group, where women show slightly better self perceived health. Ethnicity The White British population show the lowest proportion (7.7%) of people reporting poor health over the last 12 months (figure 2.2). The highest proportion, by some distance, is seen in the Asian Pakistani group, with 19.4% of the adult population experiencing poor health. This is the only group with a significantly higher proportion than the White British population. The Health Survey for England 2004, found that levels of poor general health in the Pakistani population were similarly high and second only to the Bangladeshi population.

Health and symptoms of poor health

General health

Deprivation

Variations across the Bolton population Age/sex Unsurprisingly, the proportion of people with self perceived poor health increases with age and those in excellent health decreases with age (figure 2.1). Interestingly, men in the youngest (18-44) and oldest (65+) age groups show larger proportions in excellent

Levels of poor health and deprivation are strongly associated. The line for poor health in figure 2.3 shows that those people living in the most deprived quintile of Bolton are three and a half times more likely to be in poor health than those living in the least deprived areas. Geography The proportion of people experiencing excellent and poor health by Middle Super Output Area is detailed in figure 2.4. Whilst no changes since the 2001 survey at this small area level are significant, it is encouraging to see that all but seven areas show increases in the proportion of population experiencing excellent health. Only 10 areas have seen an increase (not significant) in the proportion reporting poor health. Figure 2.5 shows the distribution of people experiencing poor health. The variation is wide, with only 2.6% in poor health in Harwood but 17.2% in Town Centre. The association with deprivation is clearly evident in this map. at

Chapter 2

In Bolton, men generally perceive their health more positively than women, with just over 25% saying they had been in fair or poor health with 29% of women ticking the same categories. Comparing to the 2001 survey we can see that the perceived health of the Bolton population has improved during the period to 2007. The proportion of people saying they have been in poor health has declined from 9.8% in 2001 to 8.2% in 2007, whilst those in excellent health, has increased from 10.8% in 2001 to 13.3% in 2007. There is a greater proportional increase in those experiencing excellent health in women than men during the period.

Female

Bolton

% Excellent

14.7

12.0

13.3

V Good

29.8

29.7

Good

30.3

29.4

29.8

Fair

17.4

20.3

18.9

Poor

7.7

8.7

8.2

Health and symptoms of poor health

General health

Deprivation

Chapter 2

Cardiovascular health As cardiovascular disease (CVD) is amongst the top causes of premature death for people in Bolton and is a major cause of lower life expectancy in Bolton, we included a number of questions in the health survey to measure the extent of associated conditions and symptoms in our population. The table below provides a quick survey results breakdown of some of these conditions by sex. Male

Female

Bolton

% In the past year, have suffered from chest pain or discomfort on exertion (may be diagnosed as angina)

9.8

8.4

9.1

Have been told they have had a heart attack

5.1

2.5

3.7

Have been told they have had a stroke

2.8

2.4

2.6

Have been told they have high blood pressure

29.6

30.1

29.9

Have been told they have diabetes

7.9

6.6

7.2

In general, men in Bolton are slightly more likely to suffer from symptoms of cardiovascular disease than women. There has been very little change in the proportions of people suffering heart attacks, strokes or suffering from angina since 2001. However, there has been an increase in the proportion of people who say they have been told they have high blood pressure and diabetes since 2001. Diabetes has risen from 5.7% to 7.2% and those being told they have high blood pressure has risen from 24.8% to 29.9%. Ordinarily, this potential rise in the prevalence of a condition would be of great concern to us. However, we believe this increase is explained by the efforts of primary care staff in recognising people with associated conditions and the attempts to get more people to report their symptoms. There is likely to be a further increase in prevalence of CVD related conditions in the coming year as people access the Big Bolton Health Check and receive what may be overdue diagnoses of CVD. Bolton has historically had higher than average levels of CVD related morbidity and mortality levels, so you would expect national comparators to be lower than the figures found in the survey. For diabetes, this is certainly true, with a figure from the Health Survey for England (2006) of 4.9%. The larger than average BME population in Bolton can account for much of this difference. Other indicators do not show that much of a difference to national comparisons.

The Annual Report of The Director of Public Health for Bolton 2008 - 2009

Geography

Age/sex

Figures 2.4 and 2.6 show the proportion of people suffering from diabetes by middle super output area. Figure 2.4 shows how only 11 areas have not seen an increase in this proportion since the last survey in 2001. However, none of the changes since 2001 are significant, apart from the overall rate for Bolton. The variation displayed in the map shows a strong association between diabetes prevalence and both ethnicity and deprivation, with the highest rates seen in Tonge Moor & Hall iâ&#x20AC;&#x2122;thâ&#x20AC;&#x2122; Wood, Town Centre, and Lower Deane & the Willows.

Ethnicity The prevalence of angina-like symptoms and diabetes by main ethnic group is displayed in figure 2.2. Evidence suggests that people of Asian and Black origin are more prone to diabetes than the white population, so it is not surprising to see much higher rates in these groups than for any of the white population groups. After adjusting for age differences, diabetes prevalence in Bolton is three times higher in the Asian Pakistani community than for Boltonâ&#x20AC;&#x2122;s population as a whole. The results suggest that one in four Asian Pakistani adults and one in five Asian Indian adults in Bolton suffer from diabetes. The highest proportions of symptoms of angina are seen in the Asian Indian population. Deprivation The lines for angina symptoms and diabetes in figure 2.3 suggest that people in the most deprived quintile in Bolton are three times more likely to suffer with angina and more than twice as likely to suffer from diabetes as people from the other end of the deprivation scale.

Respiratory health As well as being amongst the top causes of death for Bolton residents, many respiratory diseases are long term conditions that people have to live with for many years, deeply affecting their quality of life. For this reason we included a number of questions (many for the first time) to measure the extent of these conditions in Bolton. The table below shows the proportion of people in 2007 suffering from these conditions by sex. Male

Female

Bolton

% Chronic cough

14.4

12.6

13.5

Chronic bronchitis

9.5

6.6

8.0

Chronic obstructive pulmonary disease (COPD)

2.9

2.6

2.7

Have suffered from shortness of breath with wheezing (asthma) in the last year

17.3

19.9

18.7

Chapter 2

As cardiovascular diseases are frequently the result and build up of the combined effects of unhealthy lifestyles, the general stresses and strains of life, opportunity and deprivation, it is not surprising to see that they are more prevalent in mid to late life. The breakdown by age group in figure 2.1 shows this, with the highest proportions for all conditions seen in the oldest age group. Each male age group generally has a higher prevalence than their female counterpart with a few exceptions for diabetes and high blood pressure.

Health and symptoms of poor health

Variations across the Bolton population

Many respiratory conditions are caused or certainly worsened by either smoking or occupational exposure to dusts, so it’s not surprising to see higher proportions for most conditions in Bolton men as they are more likely to smoke and work in such industries. However, like most other conditions, men are less likely to consult their GP about their respiratory condition. For instance, 54% of men with symptoms of a chronic cough had not seen their GP about it compared to 38% of women.

Variations across the Bolton population Age/sex Unsurprisingly, respiratory conditions become more prevalent with age. The breakdown of respiratory conditions by age/sex groups in figure 2.1 conveys this evidence. The male age group proportion is always higher for chronic cough, chronic bronchitis and COPD. The reverse is the case for symptoms of asthma, where the proportions for women are higher. This is due to the reasons given earlier, in that smoking and occupation play a major role in the chronic respiratory diseases that men are more likely to be at risk from. Ethnicity The White Irish and Asian Pakistani populations show the highest levels (19.4%) of chronic cough in figure 2.2, with the Black population showing by far the lowest (4.6%). The high figure in the Asian Pakistani population is a little surprising, when put in the context of a lower smoking prevalence rate for this particular population (see Chapter 4). For symptoms of asthma, the Asian Pakistani population again display the highest level, with more than a quarter of the population suffering with these symptoms.

The Annual Report of The Director of Public Health for Bolton 2008 - 2009

Deprivation People living in areas that feature within the most deprived quintile of Bolton, are almost four times as likely to suffer from COPD than their least deprived counterparts (figure 2.3). They are also twice as likely to suffer from symptoms of asthma. Geography The distribution of the prevalence of COPD within Bolton is shown in figures 2.4 and 2.7. We can not compare the results for this to 2001 as the questions were not included in our previous survey. The variation across Bolton is massive, ranging from just 0.3% in Egerton & Dunscar to 8.2% in Tonge Moor & Hall i’th’ Wood. The geographical pattern displayed in the map correlates well to the pattern of smoking prevalence in Chapter 4.

The debilitating effects of bodily pain, backache and associated mobility problems can affect a personâ&#x20AC;&#x2122;s ability to earn a living, their relationships, their mental well-being and all round quality of life. The table below details the extent to which residents of Bolton suffered from such problems in 2007. Male

Female

Bolton

% Have suffered from severe bodily pain in the last 4 weeks

9.1

12.3

10.8

Have suffered from recurring or constant backache in the past year

32.7

35.1

34.0

Mobility difficulties with the lower limbs (e.g. difficulty walking up or down stairs)

17.1

21.4

19.3

Mobility difficulties with the upper limbs (e.g. difficulty holding, gripping or turning things)

9.9

18.1

14.1

Mobility difficulties concerning the back (e.g. difficulty bending or straightening up)

15.6

18.5

17.1

Health and symptoms of poor health

Pain, backache and mobility difficulties

Chapter 2

Bolton women are generally more likely to suffer with pain or have mobility difficulties than men. This is particularly evident with mobility difficulties concerning the upper limbs where the proportion is almost doubled in women. The fact that over one third of all adults in Bolton had suffered from recurring or constant backache in the past year is further compounded by that fact that, 57% of those sufferers did not go to see their GP about it. Recurring or constant back ache is the only variable to show a significant change since the last survey in 2001 (increasing from 30%).

Variations across the Bolton population

Geography

Age/sex

The proportion of people experiencing severe bodily pain in Bolton has not changed since 2001 and so there is a mixed change outlook in table 2.4 showing the prevalence of severe bodily pain by Middle Super Output Area. Slightly more areas have seen an increase in the prevalence of severe bodily pain but none have increased significantly. Figure 2.8 shows the distribution of those experiencing severe bodily pain, with areas such as Town Centre, Lever Edge, Tonge Fold and Highfield & New Bury amongst the highest.

Once again, as you would expect, severe bodily pain and mobility difficulties become more prevalent as age increases (figure 2.1). Female proportions are generally higher than for males and this is particularly evident in the 65+ age groups. It is surprising to see almost three out of ten 18-44 year olds had recurring or constant backache in the last year. Ethnicity After adjusting for age, the Asian Pakistani population have levels of severe bodily pain (22.1%) and mobility difficulties concerning the back (34.5%), significantly higher than most of the other main ethnic population groups (figure 2.2). These levels are twice as high as those seen in the White British population. Deprivation Levels of both bodily pain and mobility difficulties are strongly associated with deprivation (figure 2.3). For instance the population living in the most deprived quintile in Bolton are three times as likely to suffer mobility difficulties concerning the lower limbs than the least deprived quintile.

The Annual Report of The Director of Public Health for Bolton 2008 - 2009

Figure 2.1

- Health and symptoms of poor health indicators by broad age/sex groups Indicator

Male age groups (%)

Female age groups (%) Bolton

18-44

45-64

65+

18-44

45-64

65+

Excellent health in the last year

21.5

9.4

5.1

16.8

10.3

4.2

13.3

Poor health in the last year

4.5

10.5

11.3

5.8

9.3

13.8

8.2

In the past year, have suffered from chest pain or discomfort on exertion (may be diagnosed as angina)

5.6

10.7

19.1

4.4

7.2

17.8

9.1

Have been told they have had a heart attack

0.7

5.5

17.1

0.3

1.6

8.0

3.7

Have been told they have high blood pressure

13.5

41.0

54.2

14.4

35.2

57.0

29.9

Have been told they have diabetes

1.8

11.7

18.4

2.4

6.8

14.9

7.2

Have a chronic cough

11.3

16.2

19.9

10.4

13.3

16.0

13.5

Have chronic bronchitis

7.0

10.9

14.0

5.1

7.1

8.9

8.0

Chronic obstructive pulmonary disease (COPD)

1.4

3.8

5.5

1.3

2.9

4.6

2.7

Have suffered from shortness of breath with wheezing (asthma) in the last year

12.8

17.9

27.7

14.3

19.5

31.4

18.7

Have suffered from severe bodily pain in the last 4 weeks

5.6

12.2

13.2

7.7

13.5

19.9

10.8

Have suffered from recurring or constant backache in the past year

29.3

36.6

34.2

28.9

36.9

45.5

34.0

Mobility difficulties with the lower limbs (e.g. difficulty walking up or down stairs)

6.3

20.0

42.1

8.0

21.2

49.5

19.3

Mobility difficulties with the upper limbs (e.g. difficulty holding, gripping or turning things)

3.7

13.2

22.0

6.0

19.3

41.5

14.1

General health

CVD health

Tables, charts and maps

Chapter 2 â&#x20AC;&#x201C; Tables, charts and maps

Respiratory health

Chapter 2

Pain and mobility problems

Fig. 2.2 2.2 Health andand symptoms of poor health indicators by indicators main ethnic group Fig. Health symptoms of poor health by main

ethnic group

45 40 35 30 %

25 20 15 10 5 0

Poor health White British

Angina White Irish

Diabetes White Other

Asian Indian

Chronic cough Asian Pakistani

Fig. andand symptoms of poor health by deprivation quintile Fig.2.3 2.3Health Health symptoms of poor health by deprivation

Asthma symptoms Black

Severe pain

Mixed/Asian Other/Other

Mobility difficulties with the back

quintile

20 % 15

Most deprived

Least deprived

Key

Poor health

Angina

Symptoms of asthma

Diabetes

COPD

Severe bodily pain

Mobility difficulties with lower limbs

Fig. 2.4

Health and symptoms of poor health indicators by Middle Super Output Area Chronic obstructive pulmonary disease

Severe bodily pain

Excellent health

Poor health

Area

Egerton & Dunscar

22.6

4.6

3.5

0.3

5.3

Bolton 002

Turton

16.2

5.0

1.0

6.7

Bolton 003

Sharples

18.4

5.0

4.7

1.9

5.7

Bolton 004

Horwich Town

10.6

10.9

4.7

2.8

9.2

MSOA Name

Bolton 001

Diabetes

Bolton 005

Sweetlove

11.5

9.9

6.4

2.4

10.8

Bolton 006

Harwood

17.5

2.6

5.9

1.8

7.6

Bolton 007

Horwich Loco

15.9

5.4

7.2

2.4

9.5

Bolton 008

Smithills N&E

14.9

7.4

6.0

1.1

10.5

Bolton 009

Blackrod

14.9

7.7

6.7

1.4

13.6

Bolton 010

Tonge Moor & Hall i'th' Wood

8.7

11.0

12.0

8.2

13.7

Bolton 011

Halliwell Rd

10.9

11.1

7.8

3.7

13.6

Bolton 012

Johnson Fold & Doffcocker

13.6

5.5

4.8

2.4

8.0

Bolton 013

Breightmet N & Withins

11.9

12.8

9.4

7.0

10.9

Bolton 014

Middlebrook & Brazley

15.5

6.1

5.7

2.4

9.0

Bolton 015

Victory

7.1

9.8

8.1

2.3

11.5

Bolton 016

Town Centre

10.2

17.2

11.6

5.8

17.9

Bolton 017

Tonge Fold

11.2

10.8

7.8

2.8

14.1

Bolton 018

Heaton

13.3

5.7

4.8

2.3

6.6

Bolton 019

Leverhulme & Darcy Lever

11.6

7.8

9.2

2.0

8.7

Bolton 020

Lostock & Ladybridge

18.6

4.2

5.5

0.9

6.5

Bolton 021

Lower Deane & The Willows

9.3

11.8

11.2

3.6

16.7

Bolton 022

Burnden

11.8

14.2

9.0

2.0

12.3

Bolton 023

Daubhill

8.8

8.5

8.2

1.3

12.9

Bolton 024

Little Lever

12.4

9.8

6.9

3.7

11.6

Bolton 025

Lever Edge

8.8

10.5

10.4

3.3

14.2

Bolton 026

Deane & Middle Hulton

13.0

7.6

9.3

2.6

13.8

Bolton 027

Moses Gate

14.8

10.5

9.1

2.0

12.0

Bolton 028

Westhoughton East

17.6

4.8

6.7

0.9

8.2

Bolton 029

Townleys

9.2

8.5

7.0

3.1

13.4

Bolton 030

Over Hulton

12.3

3.8

7.0

1.9

10.7

Bolton 031

Wingates & Washacre

12.7

10.5

7.1

4.0

12.6

Bolton 032

Central Farnworth

13.9

8.0

6.7

4.7

11.3

Bolton 033

Highfield & New Bury

10.3

9.9

9.2

4.9

14.0

Bolton 034

Central Kearsley

14.8

7.3

6.9

2.4

11.1

Bolton 035

Daisy Hill

17.9

6.2

4.8

2.3

7.6

13.3

8.2

7.2

2.7

10.8

Bolton Key

Positive change since 2001 (significant)

Positive change since 2001 (not significant)

Negative change since 2001 (not significant)

Negative change since 2001 (significant)

No change / not comparable to 2001 survey

Fig. 2.5

Over the last 12 months my health has been poor

Egerton & Dunscar

Turton

Sharples

Smithills N&E

Horwich Loco

Harwood

Horwich Town Sweetlove Blackrod

Tonge Moor & Hall i’th’ Wood

Halliwell Rd

Johnson Fold & Doffcocker

Breightmet N & Withins

Town Centre

Victory

Tonge Fold Middlebrook & Brazley

Bolton 8.2% (7.7-8.7%)

Heaton Lostock & Ladybridge

Leverhulme & Darcy Lever Burnden

Daubhill

% of population

Little Lever Wingates & Washacre

14.2 to 17.3 11.3 to 14.2 8.4 to 11.3 5.5 to 8.4 2.6 to 5.5

Lower Deane & The Willows

Lever Edge

Moses Gate

Westhoughton East Townleys Deane & Middle Hulton Over Hulton

Central Farnworth Highfield & New Bury Central Kearsley

Daisy Hill

Bolton Health Survey 2007

Over the last 12 months my health has been poor 2.5 20

Fig. 2.6

Diabetes

Egerton & Dunscar

Turton

Sharples

Smithills N&E

Horwich Loco

Harwood

Horwich Town Sweetlove Blackrod

Tonge Moor & Hall i’th’ Wood

Halliwell Rd

Johnson Fold & Doffcocker

Breightmet N & Withins

Town Centre

Victory

Tonge Fold Middlebrook & Brazley

Bolton 7.2% (6.7-7.7%)

Heaton Lostock & Ladybridge

Leverhulme & Darcy Lever Burnden

Daubhill

% of population

Little Lever Wingates & Washacre

10.2 to 12.1 8.5 to 10.2 6.8 to 8.5 5.1 to 6.8 3.4 to 5.1

Lower Deane & The Willows

Lever Edge

Moses Gate

Westhoughton East Townleys Deane & Middle Hulton Over Hulton

Central Farnworth Highfield & New Bury Central Kearsley

Daisy Hill

Bolton Health Survey 2007

Diabetes 2.6

Fig. 2.7

Chronic Obstructive Pulmonary Disease

Egerton & Dunscar

Turton

Sharples

Smithills N&E

Horwich Loco

Harwood

Horwich Town Sweetlove Blackrod

Tonge Moor & Hall i’th’ Wood

Halliwell Rd

Johnson Fold & Doffcocker

Breightmet N & Withins

Town Centre

Victory

Tonge Fold Middlebrook & Brazley

Bolton 2.7% (2.4-3.0%)

Heaton Lostock & Ladybridge

Burnden

Little Lever Wingates & Washacre

Lever Edge

Moses Gate

Westhoughton East Townleys Deane & Middle Hulton Over Hulton

Central Farnworth Highfield & New Bury Central Kearsley

Daisy Hill

Bolton Health Survey 2007

Chronic obstructive pulmonary disease 2.7 22

Leverhulme & Darcy Lever

Daubhill

% of population 6.6 to 8.2 5.0 to 6.6 3.4 to 5.0 1.8 to 3.4 0.2 to 1.8

Lower Deane & The Willows

Fig. 2.8

Have suffered from severe bodily pain in the past 4 weeks

Egerton & Dunscar

Turton

Sharples

Smithills N&E

Horwich Loco

Harwood

Horwich Town Sweetlove Blackrod

Tonge Moor & Hall iâ&#x20AC;&#x2122;thâ&#x20AC;&#x2122; Wood

Halliwell Rd

Johnson Fold & Doffcocker

Breightmet N & Withins

Town Centre

Victory

Tonge Fold Middlebrook & Brazley

Bolton 10.8% (10.2-11.3%)

Heaton Lostock & Ladybridge

Leverhulme & Darcy Lever Burnden

Daubhill

% of population

Little Lever Wingates & Washacre

15.2 to 17.9 12.7 to 15.2 10.2 to 12.7 7.7 to 10.2 5.2 to 7.7

Lower Deane & The Willows

Lever Edge

Moses Gate

Westhoughton East Townleys Deane & Middle Hulton Over Hulton

Central Farnworth Highfield & New Bury Central Kearsley

Daisy Hill

Bolton Health Survey 2007

Have suffered from severe bodily pain in the past 4 weeks 2.8

Back to Contents Page

Chapter 3 Use of health services

The Annual Report of The Director of Public Health for Bolton 2008 - 2009

Obviously there is no ideal number of times that we want residents of Bolton to have visited their GP in a given year, as it is dependent on so many factors, but the fact that men are far less likely to visit their GP with a health problem is not surprising as this has been commonly found in research. It is then perhaps encouraging to see, that a reduced proportion of men in the 2007 survey (18.4%) had not visited their GP at all when compared to the survey findings in 2001 (21.7%). This same pattern is also evident in women (10.5% in 2001 to 9.1% in 2007). Number of GP visits in the last year

Male

Female

Bolton

% None at all

18.4

9.1

13.6

Only once

20.7

15.5

18.0

2-3 times

31.2

35.4

33.4

4-5 times

14.0

17.8

16.0

6 plus times

15.6

22.2

19.0

Variations across the Bolton population

Use of health services

Men in Bolton are far less likely to visit their GP than women. The table below shows the number of times that adults in Bolton said they had visited their doctorâ&#x20AC;&#x2122;s surgery or health centre, or been visited at home by their doctor, over the last twelve months. Men are twice as likely to have not visited their GP at all and are also far less likely to have made six or more visits in the past year than women. Overall, almost one in five adults had visited their GP on 6 or more occasions in the last year, with approximately one in seven making no visits at all.

Half of all adults in Bolton said that they were currently taking prescribed medicines at the time of the survey. Women were slightly more likely to be taking medication (54% women, 47% men). The proportion on medication has increased slightly since the 2001 survey (47.6% to 50.6%).

Age/sex As you might expect, the number of GP visits and likelihood of being on prescribed medication increases with age (figure 3.1). Almost a quarter of 18-44 year old men in Bolton had not visited their GP surgery at all in the previous year, while more than a quarter of men aged 65 and over had made six or more visits. The overwhelming majority of older people are taking some form of prescribed medication. Ethnicity There are no significant differences between the main ethnic groups when looking at the proportions of people who had not visited their GP at all in the previous year (figure 3.2). However, when looking at those people who had seen their GP six or more times, the Asian Pakistani population have a significantly higher proportion than any other group (39.6%). This is more than twice the proportion for the White British population. There are no significant differences between the ethnic groups when it comes to taking prescribed medication, with the White Irish population slightly more likely than the other groups. Deprivation Generally, the more deprived the population, the more likely they are to have frequently visited their GP

Chapter 3

Use of GP services and medicines

surgery (figure 3.3), with almost one in four people in the most deprived quintile having visited their GP on six or more occasions. They are also slightly more likely to be on prescribed medication than the least deprived population.

‘Do not like dental treatment’ ‘Was not sent an appointment’ ‘Did not like the last dentist’ ‘Have never been to a dentist’ ‘Other’

Geography

Eyesight test

The map in figure 3.5 (and first column in figure 3.4) shows the proportion of people who had visited their GP six or more times in the previous year by MSOA. Areas such as Town Centre, Tonge Moor & Hall i’th’ Wood, and Sweetlove show the largest proportions. No change at this level since 2001 is significant but for the majority of areas the percentage has fallen.

More than a third of Bolton adults (38.7%) had not had an eyesight test in the last two years. Once again, men are less likely to have been to their optician for a test than women (43.7% men, 34.1% women). The overall percentage has fallen since 2001 (41.2%).

Whilst not mapped, figure 3.4 also shows the proportion of adults who were currently taking prescribed medicines at the time of the 2007 survey. In the majority of areas, the proportion has risen since 2001, but only significantly in Harwood and Little Lever. The highest levels are seen in Tonge Moor & Hall i’th’ Wood and Town Centre.

Other regular health checks Dental check up A quarter of the Bolton adult population had not had a dental check up in the last two years. This proportion has very slightly decreased since 2001. Men are more likely to have not had a check up than women (28.2% men, 22.4% women). We asked those people who had not had a dental check up in the last two years for the reasons for this. The answers break down as follows (more than one answer was possible): ‘Did not see the any need to’ ‘Could not get to see a NHS dentist’ ‘Could not afford it’

28.7% 28.1% 16.0%

The Annual Report of The Director of Public Health for Bolton 2008 - 2009

14.6% 5.4% 4.5% 3.9% 15.4%

Geography

Age/sex

The majority of MSOAs have shown a reduction (albeit non significant) in the proportion of people reporting they had not had an eyesight test or dental check up in the last two years since the last survey in 2001 (figure 3.4). Figures 3.6 and 3.7 show that the highest levels of no recent dental checks and eyesight tests are in similar areas, in the central parts of Bolton.

The oldest age groups are less likely to have visited their dentist for a check up than the younger age groups (figure 3.1), with a third of people aged 65 plus not having had a check up in the last two years. This is almost certainly related to a proportion of this age group no longer having their own teeth and hence seeing no need, whether rightly or wrongly, for dental care. Three in ten younger men had also not had a recent check up. The younger the population, the less likely they are to have had their eyesight tested in the last two years, with 58% of men aged 18-44 and 46% of women in the same age group, not having had a test. Whilst the oldest age groups are most likely to have had an eyesight test there is still a considerable proportion that had not (23% men, 18% women). Ethnicity The Black population of Bolton are the least likely to have been for a recent dental or eyesight test (figure 3.2). The White population groups are the most likely to have had a dental check up in the last two years whilst the Asian Indian and Pakistani populations are the most likely to have had an eyesight test.

Use of health services

Variations across the Bolton population

Access issues The health survey included a question about how well placed the respondent thought their home was for accessing a range of services in Bolton. In this section, we look at those people who felt they are badly placed for those services within a health context, ‘your doctor’s surgery’ and ‘the nearest hospital with a casualty department’. Many factors such as public transport, availability of own transportation and location of GP practice, could affect a person’s response to this question. It is pleasing to see that only 6.9% of adults in Bolton felt that their home was badly placed for access to their doctor’s surgery. This has fallen from 9.2% in 2001 and may reflect both the recent increase in GP practices and GPs and also the location and development of new primary care facilities across Bolton.

The lack of a recent dental check up is very well correlated with deprivation (figure 3.3), with the most deprived population almost three times more likely to have not had a check up in the last two years. The association between deprivation and no recent eyesight test is not as strong but those in the most deprived areas are still more likely to have not had a recent eye test.

A fifth of people in Bolton felt that their home was badly placed for the nearest hospital with a casualty department. Surprisingly this has dropped significantly since the last survey in 2001 from 32.8%. Whilst the casualty department at the Royal Bolton Hospital has not moved during this time, we can only reflect that perhaps in 2001, people were still aware that the nearest casualty department had moved out from the town centre several years before to its new home.

Chapter 3

Deprivation

Variations across the Bolton population

Deprivation

Age/sex

The ‘not well placed for GP surgery’ line in figure 3.3 shows that there is no association with deprivation. There was even less of an association with the ‘not well placed for the nearest hospital with a casualty department’ indicator.

It is not surprising to see in figure 3.1 that the older age groups are more likely to feel their home is badly placed for these health services. As we have seen they are more likely to utilise GP services and tend to perhaps rely more on public transport than other age groups. One in ten people aged 65 and over felt that their home was not well placed for their GP surgery. Ethnicity Figure 3.2 only shows how the ethnic groups differ in their feelings of being badly placed for access to their doctor’s surgery, as including the casualty department indicator would only really reflect upon where the concentrations of each population are located in proximity to the hospital. None of the very small differences by ethnic group for the GP indicator are significant.

The Annual Report of The Director of Public Health for Bolton 2008 - 2009

Geography All but four MSOAs show an improvement in the proportion of people feeling their home is not well placed for access to their doctor’s surgery since 2001 (figure 3.4), however, no improvement is significant. Figure 3.8 shows that residents of Moses Gate and Over Hulton felt that they are the worst placed for their doctor’s surgery. This may be affected by the road network in these areas making travel to and from the surgeries more difficult.

Figure 3.1

- Use of health care indicators by broad age/sex groups Indicator

Male age groups (%)

Female age groups (%)

Bolton

18-44

45-64

65+

18-44

45-64

65+

No visits to see the GP in the last year

24.2

15.3

7.8

9.5

10.3

6.3

13.6

Six plus visits to see the GP in the last year

9.4

18.5

27.7

18.9

21.3

30.0

19.0

Currently taking prescribed medicines

26.9

58.4

83.1

33.9

61.1

87.6

50.6

No dental check up in the last two years

29.1

23.5

34.1

19.6

16.7

34.3

25.2

No eyesight test in the last two years

58.2

32.1

23.4

46.3

26.0

18.3

38.7

Home is not well placed for the doctorâ&#x20AC;&#x2122;s surgery

5.7

6.4

9.1

5.2

7.8

10.8

6.9

Home is not well placed for the nearest hospital with a casualty department

18.8

21.9

25.2

14.8

20.9

29.0

20.4

GP visits & medication

Tables, charts and maps

Chapter 3 â&#x20AC;&#x201C; Tables, charts and maps

Regular health checks

Chapter 3

Health care access

Fig. of of health service indicators by main ethnic group Fig.3.2 3.2Use Use health service indicators by main

ethnic group

80 70 60

50 40 30 20 10 0

No GP visits White British

6+ GP visits White Irish

White Other

Taking medicines Asian Indian

Asian Pakistani

Fig. of health serviceservice indicators by deprivation Fig.3.3 3.3Use Use of health indicators byquintile deprivation

No dental check Black

No eyesight test

Not well placed for GP

Mixed/Asian Other/Other

quintile

% 30

Most deprived

Least deprived

Key

No GP visits

No dental check

Taking medicines

6+ GP visits

No eyesight test

Not well placed for GP

Fig. 3.4

Use of health service indicators by middle super output area

6+ visits to GP in last year MSOA Name

No dental check up in last 2 years

No eyesight test in last 2 years

Taking prescribed medicines

Home is not well placed for access to GP

Home is not well placed for access to a hospital

Area

Egerton & Dunscar

14.0

9.9

36.5

41.7

5.4

35.1

Bolton 002

Turton

18.8

11.8

31.4

48.3

8.4

38.1

Bolton 003

Sharples

16.1

17.5

32.4

47.0

6.2

34.8

Bolton 004

Horwich Town

21.9

26.9

37.3

50.9

3.0

32.2

Bolton 005

Sweetlove

26.0

24.2

41.8

49.2

7.7

32.2

Bolton 006

Harwood

15.7

12.2

36.7

57.0

4.6

31.1

Bolton 007

Horwich Loco

15.8

21.1

36.6

49.4

5.2

31.9

Bolton 008

Smithills N&E

13.8

19.1

32.9

55.2

8.0

30.4

Bolton 009

Blackrod

17.1

24.2

40.0

51.3

4.9

18.4

Bolton 010

Tonge Moor & Hall i'th' Wood

26.8

42.8

42.7

60.0

10.0

43.4

Bolton 011

Halliwell Rd

24.1

32.1

46.5

50.9

5.4

34.0

Bolton 012

Johnson Fold & Doffcocker

17.7

15.9

35.0

53.0

7.7

36.0

Bolton 013

Breightmet N & Withins

19.1

33.6

41.7

54.0

10.5

38.9

Bolton 014

Middlebrook & Brazley

18.1

19.8

35.3

52.8

8.9

25.1

Bolton 015

Victory

21.6

30.4

42.3

50.7

7.7

33.6

Bolton 016

Town Centre

27.8

44.4

45.6

57.3

5.4

26.0

Bolton 017

Tonge Fold

19.9

29.5

38.9

52.5

5.9

22.8

Bolton 018

Heaton

15.8

17.5

36.6

45.5

3.6

24.3

Bolton 019

Leverhulme & Darcy Lever

18.3

21.7

34.4

51.1

9.3

20.3

Bolton 020

Lostock & Ladybridge

10.1

14.8

35.1

48.0

7.9

13.5

Bolton 021

Lower Deane & The Willows

24.6

40.5

42.9

47.0

5.3

25.2

Bolton 022

Burnden

24.8

33.9

45.0

48.6

10.6

1.9

Bolton 023

Daubhill

21.2

31.4

41.9

43.4

4.2

9.3

Bolton 024

Little Lever

18.4

21.5

35.7

55.8

3.1

4.3

Bolton 025

Lever Edge

23.3

37.5

42.9

51.6

9.6

4.4

Bolton 026

Deane & Middle Hulton

19.1

26.2

41.1

51.5

5.6

8.2

Bolton 027

Moses Gate

22.8

37.6

44.3

47.4

14.8

0.0

Bolton 028

Westhoughton East

15.6

15.4

32.2

49.4

6.1

8.9

Bolton 029

Townleys

18.5

27.6

41.6

54.3

8.3

0.3

Bolton 030

Over Hulton

14.4

19.5

35.1

53.7

12.8

5.3

Bolton 031

Wingates & Washacre

21.7

30.3

42.2

48.3

6.0

17.2

Bolton 032

Central Farnworth

18.2

30.2

37.3

51.5

2.5

1.6

Bolton 033

Highfield & New Bury

19.1

33.5

41.8

50.0

6.5

1.1

Bolton 034

Central Kearsley

18.1

28.9

38.0

50.2

6.0

6.7

Bolton 035

Daisy Hill

14.8

17.0

41.7

42.1

10.1

15.2

19.0

25.2

38.7

50.6

6.9

20.4

Bolton 001

Bolton Key

Positive change since 2001 (significant)

Positive change since 2001 (not significant)

Negative change since 2001 (not significant)

Negative change since 2001 (significant)

No change / not comparable to 2001 survey

Fig. 3.5

Six or more visits to the GP in the last year

Egerton & Dunscar

Turton

Sharples

Smithills N&E

Horwich Loco

Harwood

Horwich Town Sweetlove Blackrod

Tonge Moor & Hall i’th’ Wood

Halliwell Rd

Johnson Fold & Doffcocker

Breightmet N & Withins

Town Centre

Victory

Tonge Fold Middlebrook & Brazley

Bolton 19% (18.3-19.8%)

Heaton Lostock & Ladybridge

Burnden

Little Lever Wingates & Washacre

Lever Edge

Moses Gate

Westhoughton East Townleys Deane & Middle Hulton Over Hulton

Central Farnworth Highfield & New Bury Central Kearsley

Daisy Hill

Bolton Health Survey 2007

Six or more visits to the GP in the last year 3.5 32

Leverhulme & Darcy Lever

Daubhill

% of population 24.1 to 27.8 20.6 to 24.1 17.1 to 20.6 13.6 to 17.1 10.1 to 13.6

Lower Deane & The Willows

Fig. 3.6

No dental check-up in the last 2 years

Egerton & Dunscar

Turton

Sharples

Smithills N&E

Horwich Loco

Harwood

Horwich Town Sweetlove Blackrod

Tonge Moor & Hall i’th’ Wood

Halliwell Rd

Johnson Fold & Doffcocker

Breightmet N & Withins

Town Centre

Victory

Tonge Fold Middlebrook & Brazley

Bolton 25.2% (24.4-26%)

Heaton Lostock & Ladybridge

Lower Deane & The Willows Burnden Daubhill

% of population

Little Lever Wingates & Washacre

37.4 to 44.5 30.5 to 37.4 23.6 to 30.5 16.7 to 23.6 9.8 to 16.7

Leverhulme & Darcy Lever

Lever Edge

Moses Gate

Westhoughton East Townleys Deane & Middle Hulton Over Hulton

Central Farnworth Highfield & New Bury Central Kearsley

Daisy Hill

Bolton Health Survey 2007

No dental check-up in the last 2 years 3.6 33

Fig. 3.7

No eyesight test in the last 2 years

Egerton & Dunscar

Turton

Sharples

Smithills N&E

Horwich Loco

Harwood

Horwich Town Sweetlove Blackrod

Tonge Moor & Hall i’th’ Wood

Halliwell Rd

Johnson Fold & Doffcocker

Breightmet N & Withins

Town Centre

Victory

Tonge Fold Middlebrook & Brazley

Bolton 38.7% (37.8-39.6%)

Heaton Lower Deane & The Willows

Lostock & Ladybridge

Burnden Daubhill

% of population

Little Lever Wingates & Washacre

43.7 to 46.6 40.6 to 43.7 37.5 to 40.6 34.4 to 37.5 31.3 to 34.4

Lever Edge

Moses Gate

Westhoughton East Townleys Deane & Middle Hulton Over Hulton

Central Farnworth Highfield & New Bury Central Kearsley

Daisy Hill

Bolton Health Survey 2007

No eyesight test in the last 2 years 3.7 34

Leverhulme & Darcy Lever

Fig. 3.8

My home is not well placed for the doctor’s surgery

Egerton & Dunscar

Turton

Sharples

Smithills N&E

Horwich Loco

Harwood

Horwich Town Sweetlove Blackrod

Tonge Moor & Hall i’th’ Wood

Halliwell Rd

Johnson Fold & Doffcocker

Breightmet N & Withins

Town Centre

Victory

Tonge Fold Middlebrook & Brazley

Bolton 6.9% (6.4-7.4%)

Heaton Lostock & Ladybridge

Leverhulme & Darcy Lever Burnden

Daubhill

% of population

Little Lever Wingates & Washacre

12.4 to 14.8 9.9 to 12.4 7.4 to 9.9 4.9 to 7.4 2.4 to 4.9

Lower Deane & The Willows

Lever Edge

Moses Gate

Westhoughton East Townleys Deane & Middle Hulton Over Hulton

Central Farnworth Highfield & New Bury Central Kearsley

Daisy Hill

Bolton Health Survey 2007

My home is not well placed for the doctor’s surgery 3.8

Back to Contents Page

Chapter 4 Lifestyles

The Annual Report of The Director of Public Health for Bolton 2008 - 2009

Variation across the Bolton population

There has been a significant reduction in the percentage of people who smoke in the borough since the last survey in 2001. In 2001, the prevalence of smoking in adults was almost 30%. In 2007, this had dropped to 23%. This reduction reflects the amount of work that NHS Bolton and our partners have put in place to reduce smoking in the borough. Importantly, it should be noted, that the health survey took place during June 2007, one month before the smoke free legislation was introduced, making it illegal to smoke in virtually all enclosed public places and workplaces. We expect the number of smokers to have fallen further since the new legislation.

Age/sex

Men in Bolton are more likely to smoke than women (25.2% of men and 20.9% of women). The proportion of women smoking has fallen at a slightly faster rate than in men (27.3% of women smoked in 2001, 31.8% of men smoked in 2001).

Figure 4.2 shows that the white population groups have a much higher rate of smoking than the other ethnic groups in Bolton, with the Irish population almost reaching one third of all adults. However, looking separately at smoking by sex between the ethnic groups shows a very different picture. In men, smoking rates in the non-white groups are just as high as other groups and it is only the very low rates of smoking in women in these groups that brings their overall smoking prevalence rate down.

The percentage of heavy smokers (20 or more cigarettes a day) in Bolton has also fallen since 2001. This has reduced from 8.6% in 2001 to 6.0% in 2007. Men in Bolton are more likely to be heavy smokers than women (7.1% men, 4.9% women).

Lifestyles

Smoking

As can be seen in figure 4.1 almost 30% of males aged 18-44 and a quarter of females of the same age were found to be current smokers. Smoking prevalence decreases as age increases as people give up smoking through life after starting at a young age. However, the largest proportion of heavy smoking is seen in mid-life (45-64) with almost a tenth of Bolton males in this age group smoking 20 plus cigarettes a day. Ethnicity

Deprivation Of all the lifestyle indicators shown in figure 4.3, smoking shows the strongest association to deprivation. Smoking levels decrease steadily as you move from the most deprived quintile through to the least deprived quintile. People in the most deprived quintile are more than twice as likely to smoke as those in the least deprived quintile. Geography There is almost a three-fold difference (12.8-35.3%) between the lowest and highest smoking rates across different MSOAs in Bolton (see figures 4.4 and 4.5). Generally, those areas in the central and more deprived

Chapter 4

Comparing smoking in Bolton to national rates is not straightforward as the most recent national figures are from 2006 and the questions used may differ slightly from those used in the Bolton Health Survey. However, the Health Survey for England for 2006 found that 24% of males and 21% females were currently smoking. The General Household Survey found smoking prevalence rates in England of 23% for men and 21% for women. However, it must be noted that both surveys include people aged from 16 years of age. These figures suggest that Bolton has a higher prevalence of smoking in men when compared nationally.

parts of Bolton show the highest proportions of smokers. Most areas show a fall in prevalence since 2001, with increases seen in only three areas. However, the only areas to show a significant decrease since 2001 are Tonge Moor & Hall iâ&#x20AC;&#x2122;thâ&#x20AC;&#x2122; Wood, Leverhulme & Darcy Lever and Westhoughton East. Although not detailed in figure 4.4, the higher proportions of ex-smokers are generally seen in areas with low rates of current smokers. These areas are commonly the less deprived areas, suggesting that people living in these areas are able to quit smoking more easily than people in more deprived parts of Bolton. After combining both current smokers and exsmokers, the lowest proportions (i.e. areas with more people who have never smoked) are seen in areas of higher than average BME population. This is mainly due to the low prevalence of smoking among Asian women in Bolton. The patterns of smoking and heavy smoking across Bolton closely resemble the patterns of smoking attributable mortality and prevalence of lung cancer seen in Bolton1. As seen earlier, smoking is strongly correlated to deprivation with the poorer communities still showing the highest prevalence rates.

Alcohol Drinking over the weekly recommended level Almost a quarter of all adults in Bolton (24.3%) drink more than the recommended weekly alcohol levels (21 units for men, 14 units for women). This has increased significantly from 19% in 2001. To calculate the weekly levels of alcohol intake, we asked survey respondents to fill in the numbers of different types of drinks they had consumed in the last 7 days. Evidence suggests that people find it difficult to accurately remember how much they drank during the previous week and The Annual Report of The Director of Public Health for Bolton 2008 - 2009

underestimate their level of drinking in such surveys, so we expect this to be an underestimated picture of actual weekly alcohol consumption. Men (29.3%) in Bolton are more likely to drink over the recommended levels than women (19.7%). However, the overall increase since 2001 has mainly been seen in women in Bolton, with the proportion increasing alarmingly from 11% to 19.7% in 2007. The proportion of men drinking over the weekly limit has increased marginally from 28.2% in 2001 to 29.3% in 2007. The latest national figures available from the General Household Survey (GHS) show that Bolton is showing similar levels of over the weekly limit alcohol intake. In 2006 the GHS found nationally that 31% of men and 20% of women drank more than they should.

Problem drinking Men who drink more than 50 units of alcohol a week and women drinking more than 35 units a week are classified as problem or severe drinkers. Almost 6% of Bolton adults are classified as such drinkers. Worryingly, the proportion of problems drinkers has increased significantly in Bolton since 2001. The proportion of women drinking at this severe level has increased three fold from 1.2% in 2001 to 3.7% in 2007. For men, during the same period, the proportion has increased from 5.6% to 7.6%. Again we feel that this is under estimates the true picture. The General Household Survey 2006 found levels of problem drinking in Great Britain in 2006 to be 8% in men and 5% in women. Another way we captured information on problem drinkers is by using the CAGE questionnaire. The CAGE questionnaire is commonly used to screen for the more severe, dependent drinker within the population.

• I have felt that I ought to cut down on my drinking • P eople have annoyed me by criticising my drinking • I have felt ashamed or guilty about my drinking • I have had a drink first thing in the morning to steady my nerves or get over a hangover Almost 5% of Bolton adults answered yes to two of the above statements (5.9% for men and 3.8% for women). In 2001, 3.3% of adults ticked two of the statements (4.5% men and 2.2% women). The increase since 2001 mirrors others alcohol indicators measured in the survey. Again there has been a bigger proportional increase in women.

Binge drinking Heavy drinking in one session or day (more than 8 units of alcohol for men and 6 units for women) is known as binge drinking. In Bolton, 28.7% of the adult population admitted to binge drinking at least once in the last week. Levels for both men and women in Bolton are higher than national averages. The Bolton Health Survey 2007 found that 34.1% of men and 23.7% of women binge drink at least once a week. This is higher than the national average, with the General Household Survey 2006 recording levels of 23% in men and 15% in women.

Age/sex

Lifestyles

Variation across the Bolton population

For men in Bolton the highest levels of drinking over the weekly limit are seen in the 45-64 age group (33.4%) but for women it is highest in the youngest age group (24.2%) (figure 4.1). For both sexes, the two age bands of 18-44 and 45-64 years show similar levels of problem drinking. Binge drinking is highest in the youngest age groups (males 38.1%, females 32.3%) for both sexes but for males a similarly high level is also seen in the 45-64 age group (37.1%). The high levels of alcohol abuse in younger women in Bolton reflects a broader national trend in the changing drinking patterns of young British women who are quickly catching up with their male counterparts. Ethnicity The White population groups have much higher rates of excessive alcohol consumption and binge drinking than other ethnic groups in Bolton (figure 4.2). This is perhaps not surprising given the cultural and religious differences seen across the minority ethnic groups. The White British population have by far the highest rates of excessive and binge drinking, with more than a third admitting to binge drinking in the last week. Deprivation The alcohol indicators in figure 4.3 show the reverse trend of the other lifestyle indicators, with the highest levels seen in the least deprived quintile and the lowest levels seen in the most deprived quintile. For instance, the least deprived quintile population (32.7%) are twice as likely to drink over the recommended weekly limit than those in the most deprived quintile (16.1%). The difference for binge drinking is not quite as stark but shows a similar trend.

Chapter 4

The individual is asked if any of the following statements apply to them (answering yes to two or more statements, detects a possible problem with alcohol abuse):

Geography Looking at figures 4.4 and 4.6, it is clear to see that the less deprived parts of the north and west of Bolton show the highest proportions of over the limit drinkers. This supports recent research evidence pointing to higher levels of drinking in professional workers in wealthier sections of society. The lower proportions seen in some central parts of the borough can be partly explained by the concentrations of BME population who, as we have seen, are culturally less likely to drink alcohol. All but seven areas have seen an increase in the proportion drinking over the recommended level since 2001. However, only six areas show significant increases (Egerton & Dunscar, Smithills N&E, Johnson Fold & Doffcocker, Middlebrook & Brazley, Lostock & Ladybridge, and Little Lever). The majority of these areas are amongst the less deprived areas of Bolton. The higher levels of alcohol consumption in the less deprived parts of Bolton, is not mirrored when looking at alcohol related mortality. As shown in a previous Public Health Annual Report, “Does wealth mean health in Bolton?”1, the highest levels of alcohol related mortality are seen in the central most deprived areas of Bolton. We need more research to understand the complex reasons why alcohol related mortality is high in such areas. It could be that other pressures of daily life affect those living in more deprived areas in a more severe manner which can be accentuated with alcohol abuse, as well as the higher prevalence of other illnesses in these areas which may be exacerbated by excess alcohol use.

Physical activity For the Bolton Health Survey 2007, we changed the question on levels of physical activity from that used in 2001, so comparison to the previous survey is impossible. This is because we were interested in what proportion of the adult population were meeting the

The Annual Report of The Director of Public Health for Bolton 2008 - 2009

recommended level of 30 combined minutes of some form of physical activity on five or more days of the previous week. After searching for an appropriate validated question, we found that no existing question would extract the information we required and so we had to design our own question (see below). Using a new question in this way can raise concerns about the validity and accuracy of the data extracted. We need to continue our work to validate the findings we report below, but in the meantime please bear this in mind when reading and using this data. During the last week, on how many days did you spend at least 30 minutes doing some of the activities below? • S ports e.g. swimming, football, tennis, hockey •G eneral keep fit e.g. gym workout, jogging, exercise class • Daily routine activities e.g. walking or cycling to work, walking to the shops, walking to collect the children from school •H ousehold activities e.g. mopping the floor, digging, DIY The activity may be in one 30 minute session or in several shorter sessions of at least 10 minutes. The activity should at least make you feel slightly out of breath. Please tick the number of days (tick just one box) 0

No days with 30 mins. of physical activity (sedentary)

30 mins. of physical activity on 1-4 days

Male

11.8

48.2

39.9

Female

8.9

46.9

44.2

Bolton

10.3

47.6

42.1

30 mins. of physical activity on 5+ days

Only 10% of survey respondents say that they had done no sessions of physical activity during the week, with men were more likely to have led a sedentary lifestyle. Almost half of the adult population (47.6%) of Bolton do some form of physical activity for at least 30 combined minutes on 1-4 days of the week. The difference between the sexes is only marginal (men 48.3%, women 46.9%). Women are more likely to have achieved the target of doing some form of physical activity on five or more days of the week (44.2% of women, 39.9% of men). The Health Survey for England 2006, using a different question, found that 34% of 16+ year olds achieved this level of physical activity.

Age/sex The physical activity analysis by broad age/sex groups produces some perhaps surprising results (figure 4.1). The levels of sedentary lifestyle follow an expected pattern of increasing proportions with age with the highest levels of inactivity seen in the oldest age groups (65+, males 15.3% and females 17.1%). However, those achieving the recommended level of physical activity on five plus days of the week, does not follow the expected pattern of less physical activity as age increases. For Bolton men, the proportion increases with age and for women the lowest level is seen in the youngest age group.

Lifestyles

Variation across the Bolton population

Ethnicity The highest levels of sedentary lifestyle (no physical activity in a week) by some margin, are seen in the Asian Pakistani population (21%) (figure 4.2). This is more common in Pakistani males than females. The other ethnic groups show similar levels of sedentary lifestyle. Deprivation The proportion of population leading a sedentary lifestyle generally follows an association with deprivation, with the highest levels seen in the most deprived quintile (13.8%) and the lowest seen in the least deprived quintile (7.8%) (figure 4.3). Geography The central and more deprived parts of the borough show the highest proportions of physical inactivity/ sedentary lifestyle (figures 4.4 & 4.7). However, only Burnden and Lever Edge are significantly higher than the average for Bolton as a whole. These are areas with higher than average levels of BME population. Areas with the highest proportions of recommended levels of physical activity include Turton, Johnson Fold & Doffcocker and Central Kearsley.

Chapter 4

The table below shows the proportion of Bolton adults achieving varying levels of physical activity during the previous week.

Body size and diet Body size People answering the survey were asked to record their height and weight. This self reporting of measurements is prone to some error or misjudgement but still provides us with important information about the changing body size of Bolton’s population over time. Height and weight measurements can be used to calculate an individual’s Body Mass Index (BMI). The index scores can be divided into four main categories (underweight – BMI <18.5, normal/desirable 18.5-24.9, overweight 25-30, obese >30). A BMI of 30 and over is estimated to double the risk of death from all causes. The table below shows the proportion of the Bolton adult population that fall into the four classifications of BMI. The results for the Health Survey for England 2006 are given alongside but comparisons must be treated with caution as this survey collected actual heights and weights by measuring people in their homes. The proportion of people in Bolton classified as overweight or obese is likely to be underestimated due to the nature of their measurement. BMI group

Bolton Health Survey (%)

Health Survey for England (%)

Male

Female

Male

Female

Underweight

1.7

2.9

1.2

2.1

Normal/desirable

40.7

50.5

31.7

41.8

Overweight

40.9

28.4

43.4

31.9

Obese

16.7

18.2

23.7

24.2

Only a small percentage of the Bolton adult population are underweight (2.3%, men 1.7%, women 2.9%). This is more likely to be evident in people of Asian origin in Bolton, who especially when young, show lower bodyweight.

The Annual Report of The Director of Public Health for Bolton 2008 - 2009

Almost half of the Bolton survey population gave height and weight measurements that calculate to a normal/ desirable BMI. This however leaves more than a third classified as overweight and a further 17.5% classified as obese. Looking at people either overweight or obese, men in Bolton have a higher proportion in this category (57.6%) as opposed to women (46.6%). However women are slightly more likely to be obese in Bolton (18.2% vs. 16.7%). The proportion of people in the obese category has risen significantly since 2001 from 13.4% to 17.5% in 2007. This mirrors national trends. The increase has been greater in Bolton men (12.3% to 16.7%) than for women (14.4% to 18.2%).

Diet Only one question about diet was included in the 2007 health survey as a separate survey is being planned to measure the borough’s eating habits. We asked people how many portions of fruit and/or vegetables they eat a day. Since 2001, the proportion of people eating five or more portions has risen significantly from 11.6% to 18.9% of the adult population of Bolton. This still leaves us some way behind the national figure of 30% (Health and Survey for England 2006) but the rise reflects some excellent work in promoting healthy eating in the borough in recent years.

Geography

Age/sex

Figure 4.8 shows the geographical pattern of those people who are classified as obese. The largest proportions can be seen in Highfield & New Bury, Leverhulme & Darcy Lever, and Breightmet N and Withins. Only four areas have seen the rate of obesity fall since 2001, but none significantly (figure 4.4). The remainder have seen obesity levels rise but significant increases are only evident in Egerton & Dunscar and Town Centre.

The middle age group (45-64) are more likely to be classified as overweight or obese for both sexes, with more than one in five men and women of this age classified as obese (figure 4.1). However, every age/sex group apart from the youngest female group has at least 50% of the population classified as overweight or obese. The youngest age group are the least likely to be eating five or more portions of fruit and vegetables a day.

Lifestyles

Variation across the Bolton population

Bolton PCT (2006), Does wealth mean health in Bolton? Director of Public Health Annual Report 2006.

Ethnicity Obesity is highest in the Asian Indian population (18.7%) followed closely by the Asian Pakistani group (18.1%) but with high levels also seen in the White British population (17.5%) and Black population (17.4%). However, no group is significantly higher or lower than any other (figure 4.2). Deprivation

Chapter 4

Once again, obesity follows other lifestyle indicators in being associated with deprivation. The highest levels of obesity are evident in the most deprived quintile (20.7%), declining steadily to the least deprived quintile (13.5%) (figure 4.3).

Chapter 4 â&#x20AC;&#x201C; Tables, charts and maps Figure 4.1

- Lifestyle and behaviour indicators by broad age/sex groups

Indicator

Male age groups (%)

Female age groups (%)

Bolton

18-44

45-64

65+

18-44

45-64

65+

Current smoker

29.8

24.7

13.5

24.4

21.3

11.2

23.0

Heavy smoker (20+ cigarettes a day)

7.1

9.4

2.7

4.8

6.2

2.7

6.0

Drinking over the recommended weekly level (men >21 units, women >14 units)

30.7

33.4

17.0

24.2

22.1

7.9

24.3

Drinking severely over the recommended weekly level (men >50 units, women >35 units)

9.0

8.3

2.1

4.5

4.6

1.0

5.6

Binge drink at least once a week

38.1

37.1

15.2

32.3

24.0

5.9

28.7

Sedentary (no days of physical activity)

10.4

11.5

15.3

6.0

7.1

17.1

10.3

5+ days a week with 30 mins of physical activity

37.4

41.7

45.1

40.6

49.2

44.8

42.1

Overweight (BMI 25-29.9)

37.4

45.9

41.4

24.3

32.5

32.3

34.4

Obese (BMI > 30)

13.7

22.0

14.7

15.3

21.3

18.6

17.5

5+ portions of fruit and veg a day

14.1

18.8

20.2

17.3

26.4

23.5

18.9

Smoking

Alcohol

Physical activity

Body size and diet

Fig. 4.2 4.2 Lifestyle andand behaviour indicators by mainindicators ethnic groupby Fig. Lifestyle behaviour health

main ethnic group

45 40 35 30 25 % 20 15 10 5 0

Smoker White British

Drink over limit White Irish

White Other

Binge drink

Asian Indian

Asian Pakistani

Fig. andand behaviour indicatorsindicators by deprivation Fig. 4.3 4.3Lifestyle Lifestyle behaviour byquintile deprivation

Sedentary Black

Obese

Mixed/Asian Other/Other

quintile

25 % 20

Most deprived

Least deprived

Key Smoker

Binge drinker

Over limit drinker

Obese

Sedentary

Fig. 4.4

Lifestyle and behaviour indicators by middle super output area

Current smokers

Drinking over the recommended limit

Binge drink at least once a week

No physical activity in a week

Physical activity on 5+ days of the week

Area

Egerton & Dunscar

13.3

38.5

40.4

6.2

40.5

15.0

Bolton 002

Turton

12.8

26.2

33.9

6.8

48.1

12.8

Bolton 003

Sharples

16.9

28.3

33.4

7.9

41.7

13.3

Bolton 004

Horwich Town

19.2

24.9

35.1

10.6

42.8

15.0

Bolton 005

Sweetlove

23.4

22.8

31.6

9.3

39.2

18.8

Bolton 006

Harwood

14.7

33.8

34.7

8.2

42.9

15.2

Bolton 007

Horwich Loco

21.2

26.4

30.5

9.0

42.0

13.8

Bolton 008

Smithills N&E

19.1

31.7

34.8

9.8

44.4

16.9

Bolton 009

Blackrod

20.0

31.1

33.4

10.0

44.0

14.7

Bolton 010

Tonge Moor & Hall i'th' Wood

35.3

21.6

27.3

14.6

40.1

22.0

Bolton 011

Halliwell Rd

26.5

14.0

17.7

12.9

39.8

15.9

Bolton 012

Johnson Fold & Doffcocker

22.7

31.1

29.7

6.4

48.5

14.2

Bolton 013

Breightmet N & Withins

33.8

23.1

28.7

10.0

45.0

22.9

Bolton 014

Middlebrook & Brazley

19.4

26.6

30.1

10.2

42.1

13.0

Bolton 015

Victory

26.5

19.2

22.4

10.1

42.7

13.6

Bolton 016

Town Centre

33.2

13.4

19.6

15.4

41.6

18.1

Bolton 017

Tonge Fold

29.7

23.9

28.7

10.5

39.6

19.1

Bolton 018

Heaton

19.7

25.0

25.2

6.6

41.4

13.2

Bolton 019

Leverhulme & Darcy Lever

22.9

29.8

34.9

9.8

40.4

23.2

Bolton 020

Lostock & Ladybridge

14.7

29.9

32.7

10.4

39.8

14.6

Bolton 021

Lower Deane & The Willows

23.7

9.6

12.8

13.6

38.6

18.6

Bolton 022

Burnden

31.6

18.4

19.4

15.8

43.5

15.9

Bolton 023

Daubhill

19.8

12.9

14.1

9.4

38.9

19.6

Bolton 024

Little Lever

21.8

28.4

33.3

9.8

44.9

20.9

Bolton 025

Lever Edge

30.2

15.0

18.1

15.4

39.9

18.3

Bolton 026

Deane & Middle Hulton

25.5

20.3

24.0

11.9

36.6

20.6

Bolton 027

Moses Gate

28.9

18.0

24.2

14.4

45.0

20.3

Bolton 028

Westhoughton East

13.2

28.2

30.7

9.3

37.5

16.6

Bolton 029

Townleys

23.7

21.5

29.3

10.3

41.8

15.6

Bolton 030

Over Hulton

17.0

25.0

30.4

8.4

40.9

15.8

Bolton 031

Wingates & Washacre

29.3

22.2

31.6

11.0

43.6

17.9

Bolton 032

Central Farnworth

28.9

25.3

31.7

9.3

42.7

21.1

Bolton 033

Highfield & New Bury

33.4

22.2

26.2

14.2

43.0

24.8

Bolton 034

Central Kearsley

23.1

26.6

33.2

10.6

46.1

20.8

Bolton 035

Daisy Hill

18.1

23.7

27.0

7.4

42.3

18.2

23.0

24.3

28.7

10.3

42.1

17.5

MSOA Name

Bolton 001

Bolton Key

Positive change since 2001 (significant)

Positive change since 2001 (not significant)

Negative change since 2001 (not significant)

Negative change since 2001 (significant)

Obese

No change / not comparable to 2001 survey

Fig. 4.5

Current smokers

Egerton & Dunscar

Turton

Sharples

Smithills N&E

Horwich Loco

Harwood

Horwich Town Sweetlove Blackrod

Tonge Moor & Hall i’th’ Wood

Halliwell Rd

Johnson Fold & Doffcocker

Breightmet N & Withins

Town Centre

Victory

Tonge Fold Middlebrook & Brazley

Bolton 23% (22.2-23.8%)

Heaton Lostock & Ladybridge

Lower Deane & The Willows

Leverhulme & Darcy Lever Burnden

Daubhill

% of population

Little Lever Wingates & Washacre

30.8 to 35.4 26.3 to 30.7 21.8 to 26.2 17.3 to 21.7 12.8 to 17.2

Lever Edge

Moses Gate

Westhoughton East Townleys Deane & Middle Hulton Over Hulton

Central Farnworth Highfield & New Bury Central Kearsley

Daisy Hill

Bolton Health Survey 2007

Current smokers 4.5 47

Fig. 4.6

Drinking more than the recommended weekly units of alcohol

Egerton & Dunscar

Turton

Sharples

Smithills N&E

Horwich Loco

Harwood

Horwich Town Sweetlove Blackrod

Tonge Moor & Hall iâ&#x20AC;&#x2122;thâ&#x20AC;&#x2122; Wood

Halliwell Rd

Johnson Fold & Doffcocker

Breightmet N & Withins

Town Centre

Victory

Tonge Fold Middlebrook & Brazley

Bolton 24.3% (23.5-25.1%)

Heaton Lostock & Ladybridge

Burnden

Little Lever Wingates & Washacre

Lever Edge

Moses Gate

Westhoughton East Townleys Deane & Middle Hulton Over Hulton

Central Farnworth Highfield & New Bury Central Kearsley

Daisy Hill

Bolton Health Survey 2007

Drinking more than the recommended weekly units of alcohol 4.6 48

Leverhulme & Darcy Lever

Daubhill

% of population 32.8 to 38.5 27.0 to 32.8 21.2 to 27.0 15.4 to 21.2 9.6 to 15.4

Lower Deane & The Willows

Fig. 4.7

No physical activity lasting 30+ minutes in the last week

Egerton & Dunscar

Turton

Sharples

Smithills N&E

Horwich Loco

Harwood

Horwich Town Sweetlove Blackrod

Tonge Moor & Hall iâ&#x20AC;&#x2122;thâ&#x20AC;&#x2122; Wood

Halliwell Rd

Johnson Fold & Doffcocker

Breightmet N & Withins

Town Centre

Victory

Tonge Fold Middlebrook & Brazley

Bolton 10.3% (9.7-10.9%)

Heaton Lostock & Ladybridge

Leverhulme & Darcy Lever Burnden

Daubhill

% of population

Little Lever Wingates & Washacre

13.7 to 15.8 11.8 to 13.6 9.9 to 11.7 8.0 to 9.8 6.1 to 7.9

Lower Deane & The Willows

Lever Edge

Moses Gate

Westhoughton East Townleys Deane & Middle Hulton Over Hulton

Central Farnworth Highfield & New Bury Central Kearsley

Daisy Hill

Bolton Health Survey 2007

No physical activity lasting 30+ minutes in the last week 4.7 49

Fig. 4.8

Body Mass Index - obese

Egerton & Dunscar

Turton

Sharples

Smithills N&E

Horwich Loco

Harwood

Horwich Town Sweetlove Blackrod

Tonge Moor & Hall i’th’ Wood

Halliwell Rd

Johnson Fold & Doffcocker

Breightmet N & Withins

Town Centre

Victory

Tonge Fold Middlebrook & Brazley

Bolton 17.5% (16.8-18.2%)

Heaton Lostock & Ladybridge

Burnden

Little Lever Wingates & Washacre

Lever Edge

Moses Gate

Westhoughton East Townleys Deane & Middle Hulton Over Hulton

Central Farnworth Highfield & New Bury Central Kearsley

Daisy Hill

Bolton Health Survey 2007

Body Mass Index - obese 4.8 50

Leverhulme & Darcy Lever

Daubhill

% of population 22.3 to 24.8 19.9 to 22.2 17.5 to 19.8 15.1 to 17.4 12.7 to 15.0

Lower Deane & The Willows

Back to Contents Page

Chapter 5 Mental health, social support and the health of carers

The Annual Report of The Director of Public Health for Bolton 2008 - 2009

The second measure that we use to gauge possible problems with mental health is called the General Health Questionnaire 12 (GHQ12) which has been used for many years to detect the presence of nonpsychotic psychiatric morbidity in the community. The questionnaire comprises twelve questions concerning general levels of happiness, experience of depressive and anxiety symptoms, and sleep disturbance over a recent period. A four point bimodal response scale for each question is added up for all twelve questions and a threshold point of four counts as a â&#x20AC;&#x2DC;high GHQ12 scoreâ&#x20AC;&#x2122; and indicates that the person may have some problems with their mental health. Just over a fifth of the adult population in Bolton have a high GHQ12 score and thus a possible mental health problem. This is a small but not significant decrease from 2001 (21.8%). Women (22.4%) in Bolton were slightly more likely to have some mental health problems than men (19.2%). The Health Survey for England also contains the GHQ12 and in 2006 found that 13.1% in England and 14.4% in the North West had possible mental health problems, suggesting above average levels in Bolton.

Age/sex The breakdown by age/sex of mental health problems seen in figure 5.1, highlights some interesting differences between the groups. Firstly, for those suffering from nervous trouble or depression, it is interesting to note that in women, the proportion is very similar throughout the age groups with only a small increase through the ages. In men, it peaks in the 45-64 age group (21.6%). For the high GHQ12 scores, the proportion decreases with age for women whilst peaking again in the 45-64 year olds in men. It is also interesting to note that the two indicators of mental health, in men, show very similar levels. For instance, 18.9% of men say that they suffered with nervous trouble or depression in the previous year and 18.5% show signs of possible mental health problems by scoring highly in the GHQ12. Again in the 45-64 year old men, the levels are very similar (21.6% with nervous trouble or depression and 21.7% with a high GHQ12). In women the indicators are not so similar. For each female age group, the proportion is higher in the self perceived indicator for nervous trouble or depression than the high GHQ12 score (possible mental health problem).

Mental health, social support and the health of carers

We included two questions in the health survey to measure the prevalence of possible problems with mental ill health in our adult population. The first was a direct question asking if the respondent had suffered with nervous trouble or depression in the previous twelve months. Almost 24% of those surveyed had suffered with such problems, which is almost identical to the survey findings in 2001. Women (28.1%) were more likely to suffer from nervous trouble or depression than men (19.4%). Four in ten such sufferers had not been to see their GP about their problem with men (47%) more likely to have not consulted their GP than women (38%).

Variations across the Bolton population

Ethnicity Whilst many of the differences by ethnicity seen in the mental health indicators shown in figure 5.2 are not significant, there are nonetheless some differences worth noting. The Asian Pakistani population show the highest levels for both indicators, with over 30% having suffered from nervous trouble and depression in the last year. The Asian Indian and Black population show the lowest levels of self perceived nervous trouble or depression but are near the top for possible mental health problems as measured by the GHQ12. This may suggest people in some communities find it more difficult to admit to suffering from mental health problems in these communities due to stigma or social pressures.

Chapter 5

Mental health

Deprivation

Variations across the Bolton population

Both mental health indicators are strongly associated with deprivation as depicted in figure 5.3.

Age/sex

Geography The areas of Tonge Moor & Hall i’th’ Wood and Town Centre show the highest levels for both mental health indicators (see figures 5.5 and 5.6). The central parts of the borough show the highest levels. None of the changes since 2001 at middle super output area level are significant.

Social support To gain a clearer understanding of levels of social support we included a question that measures the perceived levels of social support in the adult population. This included seven questions about the physical and emotional aspects of social support aimed at finding out about the levels of support and encouragement received from family and friends. As in the GHQ12, scores are given for each answer and a maximum score of 21 is classified as having no lack of social support. Those with a score between 18-21 are classified as having some lack of social support and those scoring less than 18 as having a severe lack of social support. In Bolton, in 2007, we found that 21.2% of the surveyed population displayed some lack of social support with a further 18.2% displaying a severe lack of social support. Men were slightly more likely to be lacking social support than women (some lack of social support – men 19.4%, women 17.1%, severe lack of social support – men 21.6%, women 20.8%). The level of severe lack of social support has risen very slightly since the last survey in 2001 (17.5% to 18.2%) and this is mainly due to an increase seen in women (16% to 17.1%).

The Annual Report of The Director of Public Health for Bolton 2008 - 2009

In the female age groups the proportion severely lacking social support falls with age (figure 5.1). In men, it peaks in the 45-64 year age group. Ethnicity The Asian Pakistani population are significantly higher than all but two of the other ethnic groups in terms of severely lacking social support, with a massive 38% of the population featuring in this social support classification group (figure 5.2). They are followed by Mixed/Asian Other/Other population group with almost 32%. The White British population of Bolton show the lowest level of severely lacking social support (16.2%), which is less than half that of the Asian Pakistani population. Deprivation People living in the most deprived areas of Bolton are two and a half times more likely to suffer from a severe lack of social support than those living in the least deprived areas (figure 5.3). This indicator has one of the strongest associations with deprivation out of all the survey indicators.

The health of carers

Figure 5.7, showing the pattern of severe lack of social support across areas of Bolton, illustrates this indicators link to deprivation. The MSOAs in the central deprived parts of Bolton such as Halliwell Road, Town Centre, Victory, Lower Deane & The Willows, Burnden and Lever Edge show the highest levels. Three in every ten adults in Town Centre and Lower Deane & The Willows are severely lacking social support. None of the changes since 2001 at this geographical level (figure 5.4) are significant.

It is commonly known that the health of carers generally suffers as a result of caring for others. Personal health needs are often neglected when faced with the priority of caring for someone else. Analysis of people who report to provide care in the Bolton Health Survey tends to agree with national research in the fact that carers in Bolton are more likely to have poor mental health and lack social support. Carers in Bolton are also more likely to suffer with bodily pain and backache. Levels of obesity are also slightly higher in carers. Carers also frequently struggle to manage financially and this is evident in the fact that Bolton carers are more likely to be unable to heat their home adequately in winter.

Carers Twelve percent of adults in Bolton provide care for someone with a long term illness or disability, other than as part of their job. Women are slightly more likely to be carers than men (13.7% vs. 10.3%). Of those people who told us about how many people they provide care for, 85% care for just one person, 11% for two people, with the remainder caring for three or more people. Two thirds of carers live in the same home as the person who they are caring for.

Mental health, social support and the health of carers

Geography

Long term illness Physical disability Loss of sight Loss of hearing Learning disability Mental health problems Dementia (incl. alzheimers) Other problems of age Other

37% 45% 11% 14% 11% 13% 12% 32% 15%

Chapter 5

Those people who were carers, were also asked about the illness or disability of the person to whom they give the most care. This was broken down as follows (more than one answer was possible):

Variations across the Bolton population

Geography

Age/sex

The highest proportions of carers are seen in Halliwell Road (17.6%), Lever Edge (15%), Little Lever (14.9%) and Wingates & Washacre (14.9%) (figure 5.4 and 5.5). However, most areas of Bolton have a level almost reaching one in ten people providing care. Little Lever is the only area that has shown a significant increase in the proportion of carers since the 2001 survey.

The distribution of carers by age/sex group (figure 5.1) may be explained by differences in the life course of men and women. The proportions of carers in the 18-44 and 45-64 age groups is higher in women than men, with almost a fifth of all women aged 45-64 providing care for someone. This may be due to the fact that daughters/mothers are more likely to take care of elderly parents, siblings or children. In older age, men are slightly more likely to be carers than women which is probably due to fewer numbers of men, and therefore husbands, needing care in the population at this age. Ethnicity In general, non-white ethnic groups are more likely to be care providers (figure 5.2). The Asian Indian population show the highest proportion with 15.5%. The nature of the extended family living together or more closely is more common place in many minority ethnic communities so this is not surprising. The age profile of carers in minority ethnic groups is also younger than in the general population. Deprivation The likelihood of being a carer and deprivation are not strongly associated as depicted by the shallow gradient of the line in figure 5.3.

The Annual Report of The Director of Public Health for Bolton 2008 - 2009

- Mental health, social support and carer indicators by broad age/sex groups

Indicator

Male age groups (%)

Female age groups (%)

Bolton

18-44

45-64

65+

18-44

45-64

65+

Have suffered from nervous trouble or depression in the last 12 months

18.9

21.6

14.9

27.6

28.0

28.5

23.9

Possible mental health problems (GHQ12 threshold)

18.5

21.7

16.1

23.4

21.7

20.7

20.8

Some lack of social support

22.5

21.4

20.0

20.5

20.2

22.0

21.2

Severe lack of social support

18.8

21.5

16.9

18.4

16.3

13.8

18.2

6.8

13.8

14.2

9.8

20.1

13.0

12.1

Mental health

Social support

Caring Care for someone with a long-term illness or disability

Mental health, social support and the health of carers

Figure 5.1

Chapter 5

Chapter 5 â&#x20AC;&#x201C; Tables, charts and maps

Fig. health, social support carer indicators by main ethnic group Fig.5.2 5.2Mental Mental health, social and support and carer indicators by

main ethnic group

50 45 40 35 30 % 25 20 15 10 5 0

Possible mental health problem (GHQ12)

Suffered with nervous trouble or depression White British

White Irish

White Other

Asian Indian

Severe lack of social support Asian Pakistani

Black

Carer

Mixed/Asian Other/Other

Fig. health, social support carer indicators by deprivation quintile Fig.5.3 5.3Mental Mental health, socialand support and carer indicators by deprivation

quintile

20 % 15

Most deprived

Least deprived

Key

Suffered with nervous trouble or depression

Severe lack of social support

Possible mental health problem (GHQ12)

Carer

Fig. 5.4

Mental health, social support and carer indicators by middle super output area Have suffered from nervous trouble or depression in the last year

MSOA Name

Possible mental health problems (GHQ12)

Severe lack of social support

Carer for someone with a long term illness or disability

Area

Egerton & Dunscar

14.6

11.4

11.5

10.2

Bolton 002

Turton

20.3

13.5

11.2

10.8

Bolton 003

Sharples

22.9

16.2

13.5

10.0

Bolton 004

Horwich Town

29.4

25.1

16.7

9.3

Bolton 005

Sweetlove

29.0

21.7

19.7

13.0

Bolton 006

Harwood

17.1

17.7

11.0

12.1

Bolton 007

Horwich Loco

19.6

18.0

15.4

9.2

Bolton 008

Smithills N&E

23.7

20.4

14.4

12.9

Bolton 009

Blackrod

20.1

19.5

13.0

11.7

Bolton 010

Tonge Moor & Hall i'th' Wood

34.8

30.7

25.8

10.2

Bolton 011

Halliwell Rd

23.4

20.6

29.1

17.6

Bolton 012

Johnson Fold & Doffcocker

21.5

22.7

16.0

12.4

Bolton 013

Breightmet N & Withins

22.3

24.1

20.2

12.4

Bolton 014

Middlebrook & Brazley

26.0

14.9

12.8

9.7

Bolton 015

Victory

31.0

24.4

26.7

9.6

Bolton 016

Town Centre

35.0

27.7

30.1

14.3

Bolton 017

Tonge Fold

28.2

21.5

18.7

13.7

Bolton 018

Heaton

22.0

21.4

12.3

11.7

Bolton 019

Leverhulme & Darcy Lever

24.1

21.4

17.0

13.2

Bolton 020

Lostock & Ladybridge

15.1

15.2

14.9

9.9

Bolton 021

Lower Deane & The Willows

25.8

27.0

29.6

9.9

Bolton 022

Burnden

26.9

22.7

26.6

9.9

Bolton 023

Daubhill

23.0

17.9

23.9

14.4

Bolton 024

Little Lever

20.6

18.3

14.1

14.9

Bolton 025

Lever Edge

30.3

27.7

27.5

15.0

Bolton 026

Deane & Middle Hulton

25.0

23.4

23.8

11.1

Bolton 027

Moses Gate

24.9

25.5

22.0

10.7

Bolton 028

Westhoughton East

16.6

16.1

12.5

Bolton 029

Townleys

26.8

24.5

19.4

12.7

Bolton 030

Over Hulton

20.9

18.9

11.5

13.5

Bolton 031

Wingates & Washacre

29.5

24.8

16.0

14.9

Bolton 032

Central Farnworth

23.8

23.1

19.5

12.7

Bolton 033

Highfield & New Bury

30.0

24.0

23.2

13.1

Bolton 034

Central Kearsley

22.1

18.5

15.9

11.0

Bolton 035

Daisy Hill

18.2

16.9

13.4

10.3

23.9

20.8

18.2

12.1

Bolton 001

Bolton Key

Positive change since 2001 (significant)

Positive change since 2001 (not significant)

Negative change since 2001 (not significant)

Negative change since 2001 (significant)

No change / not comparable to 2001 survey

Fig. 5.5

Nervous trouble or depression

Egerton & Dunscar

Turton

Sharples

Smithills N&E

Horwich Loco

Harwood

Horwich Town Sweetlove Blackrod

Tonge Moor & Hall i’th’ Wood

Halliwell Rd

Johnson Fold & Doffcocker

Breightmet N & Withins

Town Centre

Victory

Tonge Fold Middlebrook & Brazley

Bolton 23.9% (23-24.8%)

Heaton Lostock & Ladybridge

Burnden

Little Lever Wingates & Washacre

Lever Edge

Moses Gate

Westhoughton East Townleys Deane & Middle Hulton Over Hulton

Central Farnworth Highfield & New Bury Central Kearsley

Daisy Hill

Bolton Health Survey 2007

Nervous trouble or depression 5.5 60

Leverhulme & Darcy Lever

Daubhill

% of population 31.0 to 35.0 26.9 to 31.0 22.8 to 26.9 18.7 to 22.8 14.6 to 18.7

Lower Deane & The Willows

Fig. 5.6

Possible mental health problems (GHQ12)

Egerton & Dunscar

Turton

Sharples

Smithills N&E

Horwich Loco

Harwood

Horwich Town Sweetlove Blackrod

Tonge Moor & Hall i’th’ Wood

Halliwell Rd

Johnson Fold & Doffcocker

Breightmet N & Withins

Town Centre

Victory

Tonge Fold Middlebrook & Brazley

Bolton 20.8% (20.1-21.6%)

Heaton Lostock & Ladybridge

Leverhulme & Darcy Lever Burnden

Daubhill

% of population

Little Lever Wingates & Washacre

27.0 to 30.7 23.1 to 27.0 19.2 to 23.1 15.3 to 19.2 11.4 to 15.3

Lower Deane & The Willows

Lever Edge

Moses Gate

Westhoughton East Townleys Deane & Middle Hulton Over Hulton

Central Farnworth Highfield & New Bury Central Kearsley

Daisy Hill

Bolton Health Survey 2007

Possible mental health problems (GHQ12) 5.6 61

Fig. 5.7

Severe lack of social support

Egerton & Dunscar

Turton

Sharples

Smithills N&E

Horwich Loco

Harwood

Horwich Town Sweetlove Blackrod

Tonge Moor & Hall i’th’ Wood

Halliwell Rd

Johnson Fold & Doffcocker

Breightmet N & Withins

Town Centre

Victory

Tonge Fold Middlebrook & Brazley

Bolton 18.2% (17.5-18.9%)

Heaton Lostock & Ladybridge

Burnden

Little Lever Wingates & Washacre

Lever Edge

Moses Gate

Westhoughton East Townleys Deane & Middle Hulton Over Hulton

Central Farnworth Highfield & New Bury Central Kearsley

Daisy Hill

Bolton Health Survey 2007

Severe lack of social support 5.7 62

Leverhulme & Darcy Lever

Daubhill

% of population 26.2 to 30.2 22.4 to 26.2 18.6 to 22.4 14.8 to 18.6 11.0 to 14.8

Lower Deane & The Willows

Fig. 5.8

Carer for someone with a long-term illness or disability

Egerton & Dunscar

Turton

Sharples

Smithills N&E

Horwich Loco

Harwood

Horwich Town Sweetlove Blackrod

Tonge Moor & Hall iâ&#x20AC;&#x2122;thâ&#x20AC;&#x2122; Wood

Halliwell Rd

Johnson Fold & Doffcocker

Breightmet N & Withins

Town Centre

Victory

Tonge Fold Middlebrook & Brazley

Bolton 12.1% (11.4-12.7%)

Heaton Lostock & Ladybridge

Leverhulme & Darcy Lever Burnden

Daubhill

% of population

Little Lever Wingates & Washacre

16.0 to 17.6 14.3 to 16.0 12.6 to 14.3 10.9 to 12.6 9.2 to 10.9

Lower Deane & The Willows

Lever Edge

Moses Gate

Westhoughton East Townleys Deane & Middle Hulton Over Hulton

Central Farnworth Highfield & New Bury Central Kearsley

Daisy Hill

Bolton Health Survey 2007

Carer for someone with a long-term illness or disability 5.8 Back to Contents Page

Chapter 6 Crime and the fear of crime

The Annual Report of The Director of Public Health for Bolton 2008 - 2009

One in four adults in Bolton had, in the last 12 months prior to the survey, personally experienced at least one of the crimes listed in the table below. Almost 9% of the adult population had personally suffered from more than one of the crimes listed in the survey. Almost 8% had experienced a racist attack (either verbal or physical). Men were slightly more likely to have experienced any of the listed crimes than women. Personal experience of crime in the last 12 months

Male (%)

Female (%)

Bolton (%)

Theft or break-in to house or flat

11.3

10.2

10.7

Theft or break-in to car parked in the area

15.8

13.9

14.8

Personal experience of theft or mugging in the area

7.5

5.9

6.7

Physical attack in the area (i.e. hit or kicked in a way that hurt you)

6.7

4.6

5.7

Racist attack in the area

8.4

6.9

7.6

Experienced at least one of the above crimes

27.6

23.4

25.4

Experienced 2 or more of the above crimes

9.6

7.8

8.7

Unfortunately, we are unable to directly compare the findings on crime related questions from the 2007 survey to the previous survey from 2001 as we used a different set of questions.

Age/sex Younger aged men (18-44) are consistently the most likely to have experienced any of the listed crimes (figure 6.1), with almost one in three experiencing at least one of the crimes. The younger age group for women are also most likely to have suffered from at least one of the crimes but they do not show the highest levels for all of the crimes. Older men and women (65+) are the most likely (along with young men) to have experienced a break-in of their home.

Crime and the fear of crime

Variations across the Bolton population

Ethnicity A significant proportion of the main minority ethnic communities in Bolton personally experienced a racist attack in the 12 months prior to the health survey. The Black population were the most likely to have experienced such a crime (25.3%), followed by Asian Indian (23.8%), Asian Pakistani (19.9%) and Mixed/ Asian Other/Other (18.7%). These four communities were also significantly more likely (more than twice as likely) to have experienced two or more of the types of crime listed in the survey, than their White British counterparts. The White Irish community had the highest proportion of population experiencing a physical attack, followed closely by the other minority ethnic groups. Deprivation The crime indicators depicted in figure 6.3 generally show quite a strong association with deprivation. For instance, people living in the most deprived quintile of Bolton are twice as likely to have personally experienced two or more crimes in the past year than those living in the least deprived quintile.

Chapter 6

Crime

Geography Figure 6.4 provides the data for three of the crime indicators at middle super output area level. It is fairly evident from this data and figures 6.5 and 6.6, that the highest levels of crime are experienced by people living in the central, more deprived and most ethnically diverse parts of Bolton. For instance, the highest levels of personal experience of physical attack are seen in residents of Town Centre, Moses Gate and Halliwell Road. Obviously, figure 6.6, showing the proportions of people experiencing racist attacks, generally depicts the concentration of minority ethnic population. However, the same areas show the highest levels of physical attack and the highest levels of experiencing more than one crime. One in five people living in Town Centre have experienced more than one type of crime in the last year.

Fear of crime Almost 7% of adults surveyed in Bolton said that they would feel unsafe walking alone in their area during the daytime. Just over 41% said they would feel unsafe walking alone after dark. Women were more likely to feel unsafe out walking during both parts of the day (during the day – men 5.4%, women 8.3%, after dark – men 29.3%, women 52.3%). Women were more than twice as likely to say that they felt unsafe alone in their home at night (men 7%, women 15.1%, overall 11.2%).

Variations across the Bolton population Age/sex There is no strong overall pattern displayed by the age and sex groups in the fear of crime indicators in figure

The Annual Report of The Director of Public Health for Bolton 2008 - 2009

6.1. The female age group is always more likely to fear crime than their male counterpart but the pattern by age shifts according to the indicator. Older women are the most likely to fear walking out alone, be it during the day or after dark. Younger men are more likely to feel unsafe in their home alone at night than older aged men. Ethnicity The White Irish population show the highest proportion of people who would not feel safe out walking alone during the day (figure 6.2), with all minority ethnic groups having larger proportions (mostly not significant) than the White British population. The Black population shows the highest level of fear for being along in the home at night with 18.7%. Deprivation Each fear of crime indicator is very strongly correlated with deprivation. For instance, people living in the most deprived quintile are six times as likely to feel unsafe out walking alone during the day as those people living in the least deprived quintile. Geography Generally those areas that have high rates of personally experienced crime also tend to have higher proportions of people feeling unsafe (figure 6.4). The majority of people living in areas such as Burnden, Town Centre, Highfield & New Bury, Halliwell Road, Tonge Moor and Hall i’th’ Wood, Lever Edge and Breightmet N & Withins, Victory, Moses Gate and Central Farnworth feel unsafe when alone in their own homes at night. Figures 6.7 and 6.8 very well depict the strong association these indicators have with deprivation.

Chapter 6 â&#x20AC;&#x201C; Tables, charts and maps Figure 6.1

- Crime and the fear of crime indicators by broad age/sex groups

Indicator

Male age groups (%)

Female age groups (%)

Bolton

18-44

45-64

65+

18-44

45-64

65+

Theft or break-in to house or flat

11.6

10.2

11.6

9.6

10.4

10.6

10.7

Theft or break-in to car parked in the area

16.9

15.2

14.0

15.4

14.2

9.3

14.8

Personal experience of theft or mugging in the area

8.0

6.5

6.9

5.2

5.7

7.0

6.7

Physical attack in the area (i.e. hit or kicked in a way that hurt you)

8.4

4.7

5.4

5.0

3.6

4.9

5.7

Racist attack in the area (either verbal or physical)

10.5

5.8

7.1

7.9

5.9

5.7

7.6

Experienced at least one of the crimes above

31.2

24.6

22.4

26.4

21.8

17.8

25.4

Experienced two or more of the above crimes

10.8

8.3

8.2

7.7

8.0

7.2

8.7

Would feel unsafe walking alone in this area during the daytime

5.7

5.0

5.3

7.1

7.3

11.1

6.9

Would feel unsafe walking alone in this area after dark

26.9

28.6

37.3

49.1

61.8

41.2

Would feel unsafe in own home at night

7.3

7.1

5.9

18.0

11.3

13.1

11.2

Personal experience of crime in the last 12 months

Fear of crime

Fig. andand the fear crimeof indicators main ethnicby group Fig.6.2 6.2Crime Crime theoffear crime by indicators main

ethnic group

35 30 25 20 % 15 10 5 0

Personal experience of a physical attack White British

White Irish

Personal experience of a racist attack White Other

Asian Indian

Personal experience of 2+ crimes Asian Pakistani

Would not feel safe out walking alone during the day Black

Fig. and and the fear of crime deprivation quintile Fig.6.3 6.3Crime Crime the fear indicators of crimebyindicators by deprivation

Would not feel safe alone at night at home

Mixed/Asian Other/Other

quintile

20 18 16 14 12 % 10 8 6 4 2 0

Most deprived

Key

Least deprived Personal experience of 2+ crimes

Personal experience of a physical attack

Would not feel safe out walking alone during the day

Personal experience of a racist attack

Would not feel safe alone at night at home

Fig. 6.4

Crime and the fear of crime indicators by middle super output area Have personally Have personally been a victim of a been a victim of a physical attack in racist attack in the the last 12 months last 12 months

MSOA Name

Have personally been a victim of more than one crime in the last 12 months

Feel unsafe walking alone in this area during daytime

Feel unsafe when alone at home at night

Area

Egerton & Dunscar

3.9

3.2

4.7

1.7

3.7

Bolton 002

Turton

3.8

2.5

5.1

1.0

5.6

Bolton 003

Sharples

4.4

7.0

7.8

2.7

4.8

Bolton 004

Horwich Town

4.7

4.3

5.9

4.6

9.3

Bolton 005

Sweetlove

3.9

6.3

7.2

5.0

8.7

Bolton 006

Harwood

5.8

5.9

8.6

3.1

7.9

Bolton 007

Horwich Loco

1.9

1.7

4.2

2.5

4.9

Bolton 008

Smithills N&E

4.3

5.0

7.4

5.3

9.3

Bolton 009

Blackrod

5.7

4.9

6.0

3.2

6.8

Bolton 010

Tonge Moor & Hall i'th' Wood

8.3

9.2

9.3

12.9

19.8

Bolton 011

Halliwell Rd

9.6

14.7

13.0

19.4

17.9

Bolton 012

Johnson Fold & Doffcocker

4.2

6.4

7.0

2.9

8.1

Bolton 013

Breightmet N & Withins

7.4

9.3

9.1

9.7

14.2

Bolton 014

Middlebrook & Brazley

5.4

6.5

7.6

2.9

6.9

Bolton 015

Victory

8.6

9.0

11.0

13.0

14.1

Bolton 016

Town Centre

10.4

17.1

20.3

12.3

22.2

Bolton 017

Tonge Fold

5.5

7.7

9.1

8.8

12.1

Bolton 018

Heaton

7.6

8.4

10.5

4.0

10.7

Bolton 019

Leverhulme & Darcy Lever

3.8

6.4

5.2

11.2

Bolton 020

Lostock & Ladybridge

2.8

4.9

3.4

2.0

7.7

Bolton 021

Lower Deane & The Willows

7.7

19.9

15.9

12.7

16.2

Bolton 022

Burnden

6.8

13.6

14.6

14.4

22.5

Bolton 023

Daubhill

7.0

13.4

12.4

8.5

11.6

Bolton 024

Little Lever

4.5

3.2

5.5

4.9

9.4

Bolton 025

Lever Edge

5.1

18.2

14.1

14.2

21.5

Bolton 026

Deane & Middle Hulton

6.6

8.2

9.5

7.7

13.9

Bolton 027

Moses Gate

10.4

12.5

15.2

10.1

15.7

Bolton 028

Westhoughton East

3.7

6.3

4.1

6.1

Bolton 029

Townleys

3.8

10.3

8.5

8.7

14.2

Bolton 030

Over Hulton

4.5

7.0

7.3

3.9

5.6

Bolton 031

Wingates & Washacre

5.3

4.4

5.7

4.4

9.6

Bolton 032

Central Farnworth

4.8

5.0

7.9

8.2

10.2

Bolton 033

Highfield & New Bury

7.8

8.0

11.3

15.2

19.3

Bolton 034

Central Kearsley

6.0

5.6

5.9

6.3

12.5

Bolton 035

Daisy Hill

6.3

7.1

8.8

4.3

6.5

5.7

7.6

8.7

6.9

11.2

Bolton 001

Bolton Key

Positive change since 2001 (significant)

Positive change since 2001 (not significant)

Negative change since 2001 (not significant)

Negative change since 2001 (significant)

No change / not comparable to 2001 survey

Fig. 6.5

Personal experience of physical attack in the area in the last 12 months

Egerton & Dunscar

Turton

Sharples

Smithills N&E

Horwich Loco

Harwood

Horwich Town Sweetlove Blackrod

Tonge Moor & Hall i’th’ Wood

Halliwell Rd

Johnson Fold & Doffcocker

Breightmet N & Withins

Town Centre

Victory

Tonge Fold Middlebrook & Brazley

Bolton 5.7% (5.2-6.1%)

Heaton Lostock & Ladybridge

Lower Deane & The Willows Burnden Daubhill

% of population

Little Lever Wingates & Washacre

8.7 to 10.5 7.0 to 8.7 5.3 to 7.0 3.6 to 5.3 1.9 to 3.6

Lever Edge

Moses Gate

Westhoughton East Townleys Deane & Middle Hulton Over Hulton

Central Farnworth Highfield & New Bury Central Kearsley

Daisy Hill

Bolton Health Survey 2007

Leverhulme & Darcy Lever

Personal experience of physical attack in the area in the last 12 months 6.5

Fig. 6.6

Personal experience of racist attack in the area in the last 12 months

Egerton & Dunscar

Turton

Sharples

Smithills N&E

Horwich Loco

Harwood

Horwich Town Sweetlove Blackrod

Tonge Moor & Hall iâ&#x20AC;&#x2122;thâ&#x20AC;&#x2122; Wood

Halliwell Rd

Johnson Fold & Doffcocker

Breightmet N & Withins

Town Centre

Victory

Tonge Fold Middlebrook & Brazley

Bolton 7.6% (7.1-8.1%)

Heaton Lower Deane & The Willows

Lostock & Ladybridge

Burnden Daubhill

% of population

Little Lever Wingates & Washacre

16.4 to 20.0 12.7 to 16.4 9.0 to 12.7 5.3 to 9.0 1.6 to 5.3

Leverhulme & Darcy Lever

Lever Edge

Moses Gate

Westhoughton East Townleys Deane & Middle Hulton Over Hulton

Central Farnworth Highfield & New Bury Central Kearsley

Daisy Hill

Bolton Health Survey 2007

Personal experience of racial attack in the area in the last 12 months 6.6

Fig. 6.7

I would feel unsafe walking alone in this area during daytime

Egerton & Dunscar

Turton

Sharples

Smithills N&E

Horwich Loco

Harwood

Horwich Town Sweetlove Blackrod

Tonge Moor & Hall iâ&#x20AC;&#x2122;thâ&#x20AC;&#x2122; Wood

Halliwell Rd

Johnson Fold & Doffcocker

Breightmet N & Withins

Town Centre

Victory

Tonge Fold Middlebrook & Brazley

Bolton 6.9% (6.5-7.4%)

Heaton Lostock & Ladybridge

Burnden

Little Lever Wingates & Washacre

Lever Edge

Moses Gate

Westhoughton East Townleys Deane & Middle Hulton Over Hulton

Central Farnworth Highfield & New Bury Central Kearsley

Daisy Hill

Bolton Health Survey 2007

Leverhulme & Darcy Lever

Daubhill

% of population 15.7 to 19.4 12.0 to 15.7 8.3 to 12.0 4.6 to 8.3 0.9 to 4.6

Lower Deane & The Willows

I would feel unsafe walking alone in this area during daytime 6.7

Fig. 6.8

I would feel unsafe alone in my own home at night

Egerton & Dunscar

Turton

Sharples

Smithills N&E

Horwich Loco

Harwood

Horwich Town Sweetlove Blackrod

Tonge Moor & Hall i’th’ Wood

Halliwell Rd

Johnson Fold & Doffcocker

Breightmet N & Withins

Town Centre

Victory

Tonge Fold Middlebrook & Brazley

Bolton 11.2% (10.6-11.8%)

Heaton Lostock & Ladybridge

Leverhulme & Darcy Lever Burnden

Daubhill

% of population

Little Lever Wingates & Washacre

18.8 to 22.5 15.0 to 18.8 11.2 to 15.0 7.4 to 11.2 3.6 to 7.4

Lower Deane & The Willows

Lever Edge

Moses Gate

Westhoughton East Townleys Deane & Middle Hulton Over Hulton

Central Farnworth Highfield & New Bury Central Kearsley

Daisy Hill

Bolton Health Survey 2007

I would feel unsafe alone in my own home at night 6.8 Back to Contents Page

Chapter 7 Neighbourhood perceptions and problems

The Annual Report of The Director of Public Health for Bolton 2008 - 2009

In the survey we included a number of questions that gather information on how people feel about the area they live in. We asked them how strongly they agree or disagree to a number of statements about their feelings for their neighbourhood. The table below shows the proportion who agree/disagree with the statement and hence show a negative response about their area. Men were slightly more likely to have given a negative response to the statements.

Male (%)

Female (%)

Bolton (%)

Bolton (2001) (%)

Disagree with the statement – Overall I am attracted to living in this area

8.6

10.7

Disagree with statement – I feel like I belong to this neighbourhood

9.5

9.2

9.3

11.4

Agree with the statement – Given the opportunity I would like to move out of this neighbourhood

29.2

25.9

27.5

27.8

Disagree with the statement – Overall I think this is a good place to bring up children

15.1

14.3

14.7

17.7

Indicator

Neighbourhood perceptions and problems

Neighbourhood perceptions

The same questions were included in the 2001 survey and it pleasing to note that for all the statements, the proportion answering negatively to each statement has decreased marginally in the latest survey.

Variations across the Bolton population Age/sex For every statement, the proportion responding negatively decreases with age (figure 7.1), with for instance, twice as many 18-44 year olds (male 34.4%, females 31.3%) wanting to move out of the neighbourhood (given the opportunity) as 65+ year olds (males 18.2%, females 16.0%). These findings are not very surprising, as older generations are generally more likely to feel more settled in, and satisfied with, their local area due to the fact that they may have been there for a longer time or may have moved around while they were younger before choosing to settle in the area.

The first two indicators in figure 7.2 show, by main ethnic group, the proportions of people who do not feel like they belong to their neighbourhood and those who do not feel their area is a good place to raise children. For both indicators it is the White Irish and White Other populations that show the highest levels of dissatisfaction.

Chapter 7

Ethnicity

It is interesting to note that the Asian Indian and Pakistani populations show the lowest level of not feeling like they belong to their neighbourhood. This reflects the commonly strong community feeling within these long established communities of Bolton. The higher level seen in the White Other population group is not surprising as this group will include more recent immigrants from Europe who will have had less time to integrate with their local neighbourhood. Deprivation The answers to all four statements show a strong association with deprivation i.e. there is a gradual reduction in the proportion of people responding negatively to the statements about their area as you move from the most deprived population through to the least deprived. Outside of the health indicators from the survey, these negative responses to neighbourhood perceptions show some of the strongest associations with deprivation. Geography Figure 7.4 details the findings for three of the neighbourhood perception indicators at MSOA level while figures 7.5 and 7.6 display these findings in map form. It is pleasing to see that the majority of areas show a reduction in the proportion of people feeling negatively about their area since 2001. Some areas such as Lever Edge show a significant improvement in the proportion of people feeling like they don’t belong to their neighbourhood and thinking the area is not a good place for bringing up children.

The Annual Report of The Director of Public Health for Bolton 2008 - 2009

The area of Tonge Moor and Hall i’th’ Wood shows the highest level of negative responses for all three neighbourhood perceptions in figure 7.4 and has also seen increases (non-significant) since 2001.

Neighbourhood problems Respondents to the health survey were asked to rate how much of a problem a number of issues were to them in the area they live in. The table shows the proportion of people who felt the issue was a serious problem in their area. It also shows how the latest survey results compare to findings from the 2001 survey. There have been some significant reductions since 2001 in issues such as vandalism, nuisance from dogs and the reputation of the neighbourhood. Issues that seem to be most seriously problematic to people in their local area include speeding traffic and the lack of safe places for children to play.

Female (%)

Bolton (%)

Bolton (2001) (%)

Vandalism

8.7

7.2

7.9

11.0

Nuisance caused by children or youngsters

15.8

15.0

15.4

14.6

Speeding traffic

19.0

19.5

19.3

18.8

Litter, smells and rubbish

11.8

11.9

11.8

12.4

People using or dealing drugs

12.3

11.4

11.8

Discarded needles and syringes

3.3

3.6

3.5

3.9

Nuisance from dogs

6.8

7.1

6.9

9.9

Uneven or dangerous pavements

12.9

15.1

14.0

Lack of safe places for children to play

19.0

20.9

20.0

20.9

Noise

8.5

8.1

8.3

8.7

Reputation of the neighbourhood

6.9

7.3

7.1

8.3

The following is a serious problem in this area:

Neighbourhood perceptions and problems

Male (%)

Indicator

Variations across the Bolton population Age/sex

Chapter 7

Generally, it is the younger generation that find neighbourhood issues highlighted in the survey to be a serious problem in their area (figure 7.1). The only issue that shows the highest proportion in those people aged 65 and over is uneven or dangerous pavements, with 15.1% of men and 19.7% of women in this age category expressing this as a serious problem.

Ethnicity

Geography

Three serious problematic neighbourhood issues that seem to show the greatest difference across ethnic groups in Bolton are shown in figure 7.2. This includes vandalism, people using and dealing drugs and nuisance from dogs. There is no overall pattern to the differences with various ethnic groups showing the highest proportions for each indicator. For instance, the White Irish population show the highest levels of concern regarding vandalism. The Asian Indian and Pakistani groups are more likely to feel that people using and dealing drugs is a serious problem in their area whilst the White Irish and Black populations show the highest rates for concern about nuisance from dogs. It is important to bear in mind that many of these differences are statistically non-significant.

It is pleasing to see that the neighbourhood problem indicators included in figure 7.4 have most commonly improved since 2001 with fewer people seeing the issues as a serious problem. In some areas, the improvement has been significant. The issue that shows the more frequently significant improvement is nuisance from dogs. Areas such as Horwich Town, Sweetlove, Horwich Loco, Johnson Fold & Doffcocker, Lostock & Ladybridge have all shown significant reductions in the number of people seeing this as a serious problem in their area since 2001. As highlighted earlier in this chapter, Tonge Moor and Hall iâ&#x20AC;&#x2122;thâ&#x20AC;&#x2122; Wood again shows the highest proportion for each indicator.

Deprivation The three serious problematic neighbourhood issues that show the strongest association to deprivation are shown in figure 7.3. These include people using or dealing drugs, noise and lack of safe places for children to play. The differences between the deprivation quintiles are large. For example, people living in the most deprived areas are thirteen times more likely to feel that people using or dealing drugs in the area is a serious problem, when compared to people living in the least deprived areas of Bolton.

Figure 7.7 displays the geographical pattern across Bolton of people responding that vandalism is a serious problem in their neighbourhood while figure 7.8 displays the reputation of the neighbourhood indicator. From these maps it is easy to see the clear association with deprivation. The highest rates are frequently seen in the most deprived central areas of the borough with a great range of difference across Bolton.

Chapter 7 – Tables, charts and maps Figure 7.1

- Neighbourhood perception and problem indicators by broad age/sex groups

Indicator

Male age groups (%)

Female age groups (%)

Bolton

18-44

45-64

65+

18-44

45-64

65+

Disagree with the statement – Overall I am attracted to living in this area

11.1

7.0

4.5

11.6

6.8

3.2

8.6

Disagree with statement – I feel like I belong to this neighbourhood

12.0

8.2

4.4

12.7

6.9

4.0

9.3

Agree with the statement – Given the opportunity I would like to move out of this neighbourhood

34.4

27.0

18.2

31.3

22.6

16.0

27.5

Disagree with the statement – Overall I think this is a good place to bring up children

18.0

13.4

9.4

17.0

11.2

10.1

14.7

Neighbourhood perceptions

Neighbourhood problems – the following is a serious problem in this area Vandalism

9.3

8.7

7.2

7.8

6.8

5.9

7.9

Nuisance caused by children or youngsters

19.1

14.5

8.7

19.3

12.1

7.8

15.4

Speeding traffic

18.7

19.4

18.9

21.7

18.1

15.9

19.3

Litter, smells and rubbish

12.6

12.5

8.4

12.5

11.7

8.9

11.8

People using or dealing drugs

14.3

11.7

6.9

13.9

10.3

5.8

11.8

Discarded needles and syringes

3.3

4.0

2.3

3.6

3.5

2.7

3.5

Nuisance from dogs

7.2

6.7

6.0

7.7

6.0

6.9

Uneven or dangerous pavements

12.2

13.0

15.1

11.6

16.1

19.7

14.0

Lack of safe places for children to play

22.5

16.5

14.2

24.7

17.6

15.4

20.0

Noise

9.5

8.0

5.9

9.6

7.2

4.8

8.3

Reputation of the neighbourhood

8.7

6.4

3.4

9.7

5.6

2.8

7.1

Fig. perception and problem indicators by main ethnic group Fig.7.2 7.2Neighbourhood Neighbourhood perception and problem indicators by

main ethnic group

35 30 25 20 % 15 10 5 0

Do not feel like I belong to this neighbourhood White British

White Irish

Do not think this is a good place to bring up children White Other

Asian Indian

Vandalism is a serious problem in this area Asian Pakistani

People using or dealing drugs is a serious problem in this area Black

Fig. perception and problemand indicators by deprivation quintile Fig.7.3 7.3Neighbourhood Neighbourhood perception problem indicators by

Nuisance from dogs is a serious problem in this area

Mixed/Asian Other/Other

deprivation quintile

20 % 15

Most deprived

Key

Least deprived People using or dealing drugs is a serious problem in this area

Do not feel like I belong to this neighbourhood

Noise is a serious problem in this area

Do not think this is a good place to bring up children

Lack of safe places for children to play is a serious problem in this area

Fig. 7.4 Neighbourhood

perception and problem indicators by middle super output area Disagree with the statement - Overall I am very attracted to living in this area

MSOA Name

Disagree with Disagree with the statement the statement - Overall I think - I feel like I this is a good belong to this place to bring neighbourhood up children

Vandalism is a serious problem in this area

Nuisance from dogs is a serious problem in this area

Reputation of the neighbourhood is a serious problem in this area

Area

Egerton & Dunscar

1.5

3.7

1.9

3.2

3.0

0.0

Bolton 002

Turton

2.2

2.7

2.6

4.8

3.7

0.0

Bolton 003

Sharples

1.7

2.4

4.6

2.7

3.7

0.5

Bolton 004

Horwich Town

5.3

6.2

7.1

9.5

6.7

1.1

Bolton 005

Sweetlove

6.5

10.2

13.6

3.9

5.4

4.4

Bolton 006

Harwood

1.8

4.5

3.4

2.9

3.8

1.0

Bolton 007

Horwich Loco

2.3

4.2

4.3

6.4

3.1

1.0

Bolton 008

Smithills N&E

1.8

3.3

7.3

3.8

6.7

1.8

Bolton 009

Blackrod

1.8

4.5

1.5

3.7

4.6

0.9

Bolton 010

Tonge Moor & Hall i'th' Wood

23.5

26.2

43.5

21.3

14.4

30.4

Bolton 011

Halliwell Rd

13.6

13.3

22.8

19.1

10.7

15.3

Bolton 012

Johnson Fold & Doffcocker

6.7

8.1

11.7

6.3

6.6

9.1

Bolton 013

Breightmet N & Withins

15.1

13.1

26.4

17.9

9.5

25.7

Bolton 014

Middlebrook & Brazley

3.1

4.2

7.2

1.4

4.1

2.1

Bolton 015

Victory

16.5

17.2

21.2

7.9

9.7

11.4

Bolton 016

Town Centre

9.8

11.9

31.9

9.1

5.5

13.0

Bolton 017

Tonge Fold

14.1

10.7

20.1

8.0

9.9

8.5

Bolton 018

Heaton

5.0

6.0

12.7

5.9

8.7

3.8

Bolton 019

Leverhulme & Darcy Lever

9.0

9.5

14.7

7.4

9.1

9.3

Bolton 020

Lostock & Ladybridge

1.9

4.1

3.1

0.3

0.9

0.6

Bolton 021

Lower Deane & The Willows

11.0

13.2

23.9

10.3

9.9

11.5

Bolton 022

Burnden

21.2

19.0

31.0

12.8

10.5

13.8

Bolton 023

Daubhill

11.2

10.6

17.8

11.5

9.5

9.9

Bolton 024

Little Lever

7.3

6.8

11.1

12.1

6.5

3.7

Bolton 025

Lever Edge

16.2

15.3

29.5

14.9

8.7

19.0

Bolton 026

Deane & Middle Hulton

7.7

8.0

16.1

5.9

6.3

4.5

Bolton 027

Moses Gate

15.0

15.5

27.2

7.0

7.7

10.9

Bolton 028

Westhoughton East

4.3

4.0

3.2

2.8

3.6

0.7

Bolton 029

Townleys

14.4

13.0

20.0

10.4

9.9

8.3

Bolton 030

Over Hulton

2.1

6.8

7.1

2.2

3.2

1.3

Bolton 031

Wingates & Washacre

7.8

8.0

14.1

5.9

6.8

3.3

Bolton 032

Central Farnworth

13.2

11.4

20.9

10.9

9.6

6.5

Bolton 033

Highfield & New Bury

20.8

21.4

30.9

16.0

12.2

18.6

Bolton 034

Central Kearsley

8.4

8.7

11.9

8.3

6.0

5.2

Bolton 035

Daisy Hill

3.8

8.4

6.3

4.6

5.2

4.0

8.6

9.3

14.7

7.9

6.9

7.1

Bolton 001

Bolton Key

Positive change since 2001 (significant)

Positive change since 2001 (not significant)

Negative change since 2001 (not significant)

Negative change since 2001 (significant)

No change / not comparable to 2001 survey

Fig. 7.5

Disagree with the statement, ‘I feel like I belong to this neighbourhood’

Egerton & Dunscar

Turton

Sharples

Smithills N&E

Horwich Loco

Harwood

Horwich Town Sweetlove Blackrod

Tonge Moor & Hall i’th’ Wood

Halliwell Rd

Johnson Fold & Doffcocker

Breightmet N & Withins

Town Centre

Victory

Tonge Fold Middlebrook & Brazley

Bolton 9.3% (8.8-9.9%)

Heaton Lostock & Ladybridge

Leverhulme & Darcy Lever Burnden

Daubhill

% of population

Little Lever Wingates & Washacre

21.5 to 26.2 16.7 to 21.5 11.9 to 16.7 7.1 to 11.9 2.3 to 7.1

Lower Deane & The Willows

Lever Edge

Moses Gate

Westhoughton East Townleys Deane & Middle Hulton Over Hulton

Central Farnworth Highfield & New Bury Central Kearsley

Daisy Hill

Bolton Health Survey 2007

Disagree with the statement, ‘I feel like I belong to this neighbourhood’ 7.5 82

Fig. 7.6

Disagree with the statement, ‘Overall I think this is a good place to bring up children’

Egerton & Dunscar

Turton

Sharples

Smithills N&E

Horwich Loco

Harwood

Horwich Town Sweetlove Blackrod

Tonge Moor & Hall i’th’ Wood

Halliwell Rd

Johnson Fold & Doffcocker

Breightmet N & Withins

Town Centre

Victory

Tonge Fold Middlebrook & Brazley

Bolton 14.7% (14-15.3%)

Heaton Lostock & Ladybridge

Leverhulme & Darcy Lever Burnden

Daubhill

% of population

Little Lever Wingates & Washacre

35.1 to 43.6 26.7 to 35.1 18.3 to 26.7 9.9 to 18.3 1.5 to 9.9

Lower Deane & The Willows

Lever Edge

Moses Gate

Westhoughton East Townleys Deane & Middle Hulton Over Hulton

Central Farnworth Highfield & New Bury Central Kearsley

Daisy Hill

Bolton Health Survey 2007

Disagree with the statement, ‘Overall I think this is a good place to bring up children’ 7.6

Fig. 7.7

Vandalism is a serious problem in this area

Egerton & Dunscar

Turton

Sharples

Smithills N&E

Horwich Loco

Harwood

Horwich Town Sweetlove Blackrod

Tonge Moor & Hall iâ&#x20AC;&#x2122;thâ&#x20AC;&#x2122; Wood

Halliwell Rd

Johnson Fold & Doffcocker

Breightmet N & Withins

Town Centre

Victory

Tonge Fold Middlebrook & Brazley

Bolton 7.9% (7.4-8.4%)

Heaton Lostock & Ladybridge

Burnden

Little Lever Wingates & Washacre

Lever Edge

Moses Gate

Westhoughton East Townleys Deane & Middle Hulton Over Hulton

Central Farnworth Highfield & New Bury Central Kearsley

Daisy Hill

Bolton Health Survey 2007

Vandalism is a serious problem in this area 7.7 84

Leverhulme & Darcy Lever

Daubhill

% of population 17.1 to 21.4 12.9 to 17.1 8.7 to 12.9 4.5 to 8.7 0.3 to 4.5

Lower Deane & The Willows

Fig. 7.8

Reputation of the neighbourhood is a serious problem in this area

Egerton & Dunscar

Turton

Sharples

Smithills N&E

Horwich Loco

Harwood

Horwich Town Sweetlove Blackrod

Tonge Moor & Hall i’th’ Wood

Halliwell Rd

Johnson Fold & Doffcocker

Breightmet N & Withins

Town Centre

Victory

Tonge Fold Middlebrook & Brazley

Bolton 7.1% (6.6-7.6%)

Heaton Lower Deane & The Willows

Lostock & Ladybridge

Burnden Daubhill

% of population

Little Lever Wingates & Washacre

24.4 to 30.4 18.3 to 24.4 12.2 to 18.3 6.1 to 12.2 0 to 6.1

Leverhulme & Darcy Lever

Lever Edge

Moses Gate

Westhoughton East Townleys Deane & Middle Hulton Over Hulton

Central Farnworth Highfield & New Bury Central Kearsley

Daisy Hill

Bolton Health Survey 2007

Reputation of the neighbourhood is a serious problem in this area 7.8

Back to Contents Page

Chapter 8 Social and economic characteristics

The Annual Report of The Director of Public Health for Bolton 2008 - 2009

The health survey included a number of questions that provide an insight into the social and economic lives of adults in Bolton. The results from these questions are listed in the table below. Males (%)

Females (%)

Bolton (%)

Finding it difficult to manage financially

12.1

9.9

11.0

Do not own their own home (either outright or through a mortgage)

24.0

25.8

25.0

In the winter, are unable to heat the home sufficiently

14.1

15.8

15.0

Do not have access to the internet at home

31.8

34.9

33.4

Do not have regular access to a car or van at home

15.1

19.6

17.4

Do not have a telephone at home

6.4

5.7

6.0

Do not have a digital television at home

14.1

15.7

14.9

Live alone

16.2

18.1

17.2

Social and economic characteristics

Socio-economic characteristics

The proportion of people who said that they were finding it difficult to manage financially has increased from 9.4% in 2001 to 11% in 2007. The proportion of adults who are not home owners has also very slightly increased from 24.1% in 2001 to 25% in 2007. The other questions were new to the 2007 survey and so comparison with 2001 is not possible. More than one in seven people felt that they were unable to heat their home as they would like during the winter months. With recent increases in energy prices, it would be fair to expect that this would now be the case for even more people.

One in six adults in Bolton said that they live on their own, which is slightly higher than the national average of 16% (General Household Survey 2006).

Chapter 8

A third of all adults in Bolton did not have access to the internet at home in 2007. This is slightly lower than a national figure of 39% found in the Office for National Statistics Omnibus Survey 2007. Other indicators include not having access to a car (17.4%), not having a telephone at home (6%) and digital television (14.9%).

Variations across the Bolton population Age/sex The youngest age groups in figure 8.1 are the most likely to be having difficulty managing financially with men more likely throughout the different age profiles. The younger age groups are also most likely to not own their own home. All age groups seem to be fairly evenly affected by the inability to heat their home sufficiently during winter months, with small peaks in the 45-64 year age band. Two thirds of people aged 65 and over in Bolton do not have access to the internet at home. It is surprising to see that even amongst the youngest age group, more than one in five people do not have internet access. The oldest age groups are less likely to have regular access to a car and a digital television at home, whilst the youngest age groups are less likely to have a home telephone, which may be due to the high ownership of mobile phones. A quarter of men aged 65 and over and more than four in every ten women aged 65 and over live on their own. Ethnicity The Black population of Bolton lead four out of the five social and economic indicators displayed in figure 8.2. They are significantly higher than the other ethnic groups for struggling to manage financially (28.2%) and not owning their own home (63.9%). They also have slightly larger proportions of population unable to heat their home satisfactorily in winter and with no home internet access. The White Irish population are more likely to live alone than any other group followed by the Black population.

The Annual Report of The Director of Public Health for Bolton 2008 - 2009

Other findings worthy of note is the high proportion of White Other population who do not own their own home and the very low proportion of Asian Indian and Pakistani population that live alone. Deprivation Unsurprisingly, all of the indicators displayed in figure 8.3 are very strongly associated with deprivation. For instance, those living in the most deprived parts of Bolton are eleven times less likely to own their own home, three times more likely to find it difficult to manage financially and be three times more likely to not be able to heat their home during the winter as those living in the least deprived areas. Geography The majority of areas in Bolton have seen an increase in the proportion of people finding it difficult to manage financially and not owning their own homes (figure 8.4) since 2001. However, only Tonge Moor & Hall i’th’ Wood and Burnden have seen significant increases for one of the respective indicators during this time. There are some very large social and economic inequalities noticeable between the areas of Bolton in figure 8.4 and the corresponding maps (figures 8.5 to 8.8). Areas such as Tonge Moor & Hall i’th’ Wood, Halliwell Road, Town Centre, Lower Deane & The Willows and Highfield & New Bury consistently show the worst social and economic conditions of any areas in Bolton.

- Social and economic indicators by broad age/sex groups

Indicator

Male age groups (%)

Female age groups (%)

Bolton

18-44

45-64

65+

18-44

45-64

65+

Finding it difficult to manage financially

15.4

11.1

4.6

13.2

8.7

3.4

11.0

Do not own their own home (either outright or through a mortgage)

28.1

18.7

22.8

28.5

17.5

27.6

25.0

During the winter, are unable to satisfactorily heat the home

13.8

14.7

13.3

15.4

16.7

13.7

15.0

Do not have access to the internet at home

23.5

28.3

60.6

21.5

27.5

70.0

33.4

Do not have regular access to a car or van at home

15.8

11.4

18.7

14.6

12.7

35.7

17.4

Do not have a telephone at home

9.1

4.5

2.1

9.3

2.5

1.2

6.0

Do not have access to a digital TV at home

12.6

13.1

20.7

10.9

11.7

30.0

14.9

Live alone

12.9

16.3

24.5

9.2

13.7

42.7

17.2

Social and economic characteristics

Figure 8.1

Chapter 8

Chapter 8 â&#x20AC;&#x201C; Tables, charts and maps

Fig. andand economic indicators by main ethnic group Fig.8.2 8.2Social Social economic indicators by main

ethnic group

80 70 60 50 % 40 30 20 10 0

Finding it difficult to manage financially White British

Do not own their own home

White Irish

White Other

Asian Indian

In the winter are unable to heat the home sufficiently Asian Pakistani

Fig. andand economic indicators by deprivation Fig.8.3 8.3Social Social economic indicators by quintile deprivation

Black

Do not have access to the internet at home

Live alone

Mixed/Asian Other/Other

quintile

40 % 30

Most deprived

Key

Least deprived In the winter are unable to heat the home sufficiently

Finding it difficult to manage financially

Do not have access to the internet at home

Do not own their own home

Live alone

Fig. 8.4

Social and economic indicators by middle super output area

Finding it difficult to manage financially

Do not own their own home

In the winter are unable to heat the home sufficiently

Do not have access to the internet at home

Area

Egerton & Dunscar

4.1

5.0

15.1

9.0

Bolton 002

Turton

5.5

6.1

7.4

20.4

10.4

Bolton 003

Sharples

5.9

6.4

8.1

24.3

16.0

Bolton 004

Horwich Town

13.7

20.1

20.6

30.7

22.7

MSOA Name

Bolton 001

Live alone

Bolton 005

Sweetlove

12.6

25.9

15.3

36.7

17.9

Bolton 006

Harwood

4.9

5.4

9.2

23.4

13.1

Bolton 007

Horwich Loco

5.7

13.5

9.0

23.2

18.9

Bolton 008

Smithills N&E

7.1

12.4

15.9

30.1

17.5

Bolton 009

Blackrod

8.0

8.4

8.8

28.1

13.6

Bolton 010

Tonge Moor & Hall i'th' Wood

26.3

54.7

22.0

41.1

27.8

Bolton 011

Halliwell Rd

19.5

45.8

25.6

48.8

24.9

Bolton 012

Johnson Fold & Doffcocker

8.3

23.1

12.6

33.5

17.1

Bolton 013

Breightmet N & Withins

13.5

51.5

19.2

43.2

23.3

Bolton 014

Middlebrook & Brazley

7.3

18.2

8.2

22.6

15.3

Bolton 015

Victory

18.0

40.6

24.6

45.2

22.0

Bolton 016

Town Centre

18.2

70.7

23.3

65.1

36.9

Bolton 017

Tonge Fold

14.9

30.7

18.0

38.7

24.1

Bolton 018

Heaton

9.1

15.4

13.8

25.9

13.6

Bolton 019

Leverhulme & Darcy Lever

10.7

20.0

13.2

32.7

12.5

Bolton 020

Lostock & Ladybridge

5.7

4.6

5.3

16.5

10.5

Bolton 021

Lower Deane & The Willows

14.8

52.1

22.8

53.3

20.2

Bolton 022

Burnden

16.4

36.5

19.6

44.8

17.0

Bolton 023

Daubhill

10.8

31.3

16.0

38.4

16.1

Bolton 024

Little Lever

8.9

14.9

14.5

29.2

12.3

Bolton 025

Lever Edge

16.1

53.0

21.6

44.8

14.4

Bolton 026

Deane & Middle Hulton

14.0

34.7

17.8

42.4

25.2

Bolton 027

Moses Gate

12.4

35.9

22.4

41.5

17.3

Bolton 028

Westhoughton East

5.8

7.9

8.6

20.8

11.9

Bolton 029

Townleys

11.5

16.4

20.3

35.4

14.2

Bolton 030

Over Hulton

6.9

9.9

11.0

24.4

12.4

Bolton 031

Wingates & Washacre

12.0

28.8

13.9

31.7

18.6

Bolton 032

Central Farnworth

11.4

34.3

14.3

43.2

25.9

Bolton 033

Highfield & New Bury

16.3

46.6

23.3

36.3

13.2

Bolton 034

Central Kearsley

9.5

18.4

13.5

32.7

14.0

Bolton 035

Daisy Hill

7.2

10.4

7.4

19.9

11.0

25.0

15.0

33.4

17.2

Bolton Key

Positive change since 2001 (significant)

Positive change since 2001 (not significant)

Negative change since 2001 (not significant)

Negative change since 2001 (significant)

No change / not comparable to 2001 survey

Fig. 8.5

Finding it difficult to manage financially

Egerton & Dunscar

Turton

Sharples

Smithills N&E

Horwich Loco

Harwood

Horwich Town Sweetlove Blackrod

Tonge Moor & Hall iâ&#x20AC;&#x2122;thâ&#x20AC;&#x2122; Wood

Halliwell Rd

Johnson Fold & Doffcocker

Breightmet N & Withins

Town Centre

Victory

Tonge Fold Middlebrook & Brazley

Bolton 11% (10.4-11.6%)

Heaton Lostock & Ladybridge

Burnden

Little Lever Wingates & Washacre

Lever Edge

Moses Gate

Westhoughton East Townleys Deane & Middle Hulton Over Hulton

Central Farnworth Highfield & New Bury Central Kearsley

Daisy Hill

Bolton Health Survey 2007

Finding it difficult to manage financially 8.5 92

Leverhulme & Darcy Lever

Daubhill

% of population 21.7 to 26.3 17.3 to 21.7 12.9 to 17.3 8.5 to 12.9 4.1 to 8.5

Lower Deane & The Willows

Fig. 8.6

During winter months, are unable to heat the home adequately

Egerton & Dunscar

Turton

Sharples

Smithills N&E

Horwich Loco

Harwood

Horwich Town Sweetlove Blackrod

Tonge Moor & Hall iâ&#x20AC;&#x2122;thâ&#x20AC;&#x2122; Wood

Halliwell Rd

Johnson Fold & Doffcocker

Breightmet N & Withins

Town Centre

Victory

Tonge Fold Middlebrook & Brazley

Bolton 15% (14.3-15.6%)

Heaton Lostock & Ladybridge

Leverhulme & Darcy Lever Burnden

Daubhill

% of population

Little Lever Wingates & Washacre

21.4 to 25.6 17.3 to 21.4 13.2 to 17.3 9.1 to 13.2 5.0 to 9.1

Lower Deane & The Willows

Lever Edge

Moses Gate

Westhoughton East Townleys Deane & Middle Hulton Over Hulton

Central Farnworth Highfield & New Bury Central Kearsley

Daisy Hill

Bolton Health Survey 2007

During winter months, are unable to heat the home adequately 8.6 93

Fig. 8.7

Live alone

Egerton & Dunscar

Turton

Sharples

Smithills N&E

Horwich Loco

Harwood

Horwich Town Sweetlove Blackrod

Tonge Moor & Hall i’th’ Wood

Halliwell Rd

Johnson Fold & Doffcocker

Breightmet N & Withins

Town Centre

Victory

Tonge Fold Middlebrook & Brazley

Bolton 17.2% (16.5-17.9%)

Heaton Lostock & Ladybridge

Burnden

Little Lever Wingates & Washacre

Bolton Health Survey 2007

Live alone 8.7 94

Leverhulme & Darcy Lever

Daubhill

% of population 31.3 to 37.0 25.7 to 31.3 20.1 to 25.7 14.5 to 20.1 8.9 to 14.5

Lower Deane & The Willows

Lever Edge

Moses Gate

Westhoughton East Townleys Deane & Middle Hulton Over Hulton

Central Farnworth Highfield & New Bury Central Kearsley

Daisy Hill

Fig. 8.8

No internet access at home

Egerton & Dunscar

Turton

Sharples

Smithills N&E

Horwich Loco

Harwood

Horwich Town Sweetlove Blackrod

Tonge Moor & Hall i’th’ Wood

Halliwell Rd

Johnson Fold & Doffcocker

Breightmet N & Withins

Town Centre

Victory

Tonge Fold Middlebrook & Brazley

Bolton 33.4% (32.5-34.3%)

Heaton Lostock & Ladybridge

Leverhulme & Darcy Lever Burnden

Daubhill

% of population

Little Lever Wingates & Washacre

55.1 to 65.2 45.1 to 55.1 35.1 to 45.1 25.1 to 35.1 15.1 to 25.1

Lower Deane & The Willows

Lever Edge

Moses Gate

Westhoughton East Townleys Deane & Middle Hulton Over Hulton

Central Farnworth Highfield & New Bury Central Kearsley

Daisy Hill

Bolton Health Survey 2007

No internet access at home 8.8 Back to Contents Page

Bolton Primary Care Trust St Peterâ&#x20AC;&#x2122;s House Silverwell Street Bolton BL1 1PP 01204 462000 www.bolton.nhs.uk